Research Foundations for Evidence-Informed Early Childhood Intervention Performance Checklists

Abstract

The research evidence for early childhood intervention practices performance checklists is described. Performance checklists include lists of the tasks or steps required to complete a practice competently. The checklists were developed using a conceptualization-operationalization-measurement framework where findings from research syntheses and empirical studies informed the selection or development of checklist indicators. This paper includes a meta-review of empirical evidence demonstrating practice-outcome relationships consistent with the purposes and goals of each of the performance checklists. Findings from more than 200 narrative reviews, meta-analyses, integrative reviews, and other types of research syntheses were the sources of evidence and foundations for 26 early childhood intervention performance checklists. The research evidence, taken together, indicates that the checklist indicators have a substantial evidence base for each of the performance checklist practices. Strengths and limitations of the meta-review are described.

1. Introduction

1.1. Background

Performance excellence is an explicit goal in most if not all professions [1,2]. According to Gawande [3], excellence is achieved by attending to the steps required to complete a task successfully, ensuring that the knowledge and skills needed to complete a task are aligned with operationally defined performance standards, and that there is intentional and deliberate monitoring of actual performance against expected performance. As also noted by Gawande [4], all of this can be accomplished by using checklists for specifying the most important steps or elements of a practice.

Checklists are now widely used in a number of fields and professions for planning, monitoring, and evaluating performance, products, and procedures [5,6,7,8,9,10]. Procedural or performance checklists include lists of the tasks, steps, or behavior indicators required to complete different practices in a competent manner [7]. Evidence-informed performance checklists include indicators based on research findings establishing an empirical relationship between the checklist practice indicators and intended or expected outcomes [11]. The reader is referred elsewhere for descriptions of the different methods and procedures for developing checklists, for example, [4,7,11,12].

Gawande [4], in his book The Checklist Manifesto: How to Get Things Right, describes two types of checklists: Do-confirm and Read-do. Do-confirm checklists are used on a post-hoc basis to determine if the checklist indicators were used as intended. Read-do checklists are used on an a priori basis to review expectant performance and which serve as mnemonic devices for increasing the likelihood that actual performance mirrors expected performance. Evidence-informed performance checklists are best described as Review-Do-Confirm tools. Checklist indicators operationally define a set of interrelated practice characteristics that “serve as concrete reminders of the tasks that need to be performed” [7] (p. 4, emphasis added) and then are used to do a self-evaluation or coach-facilitated evaluation of how well one was able to complete the tasks as operationally defined.

This paper includes (1) an overview of the procedures used to develop evidence-informed early childhood intervention performance checklists; (2) brief descriptions of 26 early childhood intervention checklists; and (3) a meta-review of the sources of research evidence for the checklist practices and practice indicators. Early childhood intervention includes the experiences and opportunities afforded young children between birth and 8 years of age and their parents or other primary caregivers to promote and enhance child, parent, and family competence and confidence [13,14,15]. The checklists were developed at the Early Childhood Technical Assistance (ECTA) Center at the University of North Carolina—Chapel Hill. The author and his colleagues at the ECTA Center developed the checklists using early childhood intervention recommended practices [16] as the foundations for (1) unpacking the recommended practices to identify internally consistent sets of practice indicators where (2) findings from research syntheses and empirical studies were used to select or develop practice indicators which research indicates are empirically related to outcomes of interest [11].

1.2. Procedure for Developing Evidence-Informed Performance Checklists

Figure 1 shows the framework used to develop the performance checklists. The framework is based on Babbie’s [17] interrelated steps of conceptualization, operationalization, and measurement. In terms of checklist development, conceptualization refers to the characteristics that define an early childhood intervention practice, operationalization refers to behavior indicators that are the key characteristics of a practice, and measurement refers to the procedures used for knowing if the practice characteristics were used as intended [18].

The performance checklist characteristics were first informed by the Council for Exceptional Children, Division for Early Childhood Early Intervention/Early Childhood Special Education Recommended Practices [16]. The Division for Early Childhood recommended practices includes seven assessment and intervention practice areas. Twenty-six checklists were developed for the seven practice areas (assessment practices, environment practices, family practices, instruction practices, interaction practices, teaming and collaboration practices, and transition practices). (An eighth practice area, leadership, has three checklists but they include neither child nor family assessment or intervention practices.)

The checklists are all formatted (organized) in the same way to facilitate practitioner understanding and use of the checklist practice indicators. As noted by Schwartz [19], “Applying organization to new learning causes the learner to focus on the meaning of the material and thus increases the depth of processing… [where] organizing what we learn into [similarly formatted] categories and meaning-based [categories and] connections…improves encoding” (p. 107).

Each checklist includes a brief description of an early childhood intervention practice and the intended outcome or benefit of the practice. The brief description also includes a statement of the intended context(s) for using the practice and how a practitioner can use the checklist indicators to prepare to implement the practice (Review-do) and to evaluate how well the practice characteristics were able to be used (Do-confirm). Each checklist includes a list of practice indicators (key elements, active ingredients, procedural steps, etc.) that, taken together, operationally define the key characteristics of a particular intervention practice. The checklists all include a 4-point Likert scale for a practitioner to do a self-evaluation of “how well” the practice characteristics were used with a child or family or for a coach or supervisor to do a coach-facilitated practitioner self-evaluation for promoting learner mastery [20]. Two options are included to accommodate individual practitioner preferences. One option permits the assessment of frequency of use (Seldom or Never to Most of the Time) whereas the other option permits the assessment of percent of time a practice was used (0–25% to 75–100%).

The practices on each checklist (e.g., naturalistic instruction) are conceptualized as a particular type of early childhood intervention practice; for example, [21]. The evidence for the checklist indicators was used to operationalize the key characteristics of the practice (e.g., following a child’s lead, sensitivity to child behavioral cues, responding promptly and positively to child behavior, and providing natural consequences to reinforce child behavior initiations as indicators of naturalistic instruction); for example, Dunst et al. [22] (p. 5). Figure 2 (p. 4) illustrates the checklist formatting for the Naturalistic Instructional Practices Checklist. The checklist includes seven key characteristics of this particular teaching strategy. The checklist also includes a description of the purpose of the practice, where and how the practice is used to facilitate and reinforce child learning, and guidelines for using the checklist to plan interventions (Read-do) and evaluate how well the practice was used with a child (Do-confirm) [4]. All of the performance checklists are formatted in an identical manner.

1.3. Evidence-Informed Performance Checklists

The following are brief descriptions of each of the evidence-informed performance checklists. The 26 checklists are listed in

Table 1. Early Childhood Assessment and Intervention Performance Checklists.

Practice Areas	Practice Areas
Assessment Checklists	Instruction Checklists
1. Authentic Child Assessment Practices	1. Embedded Instruction Practices
2. Building on Child Strengths Practices	2. Naturalistic Instruction Practices
3. Engaging Families as Partners	3. Systematic Instruction Practices
4. Informed Clinical Reasoning	Interaction Checklists
Environment Checklists	1. Adult-Child Interaction Practices
1. Assistive Technology	2. Child-Child Interaction Practices
2. Child Physical Activity	3. Child Social-Communication Interactions
3. Environmental Adaptations	4. Child Social-Emotional Competence
4. Environmental Arrangements	Teaming and Collaboration Checklists
5. Natural Learning Opportunities	1. Collaboration to Learn and Grow
Family Checklists	2. Communication for Teaming
1. Family Capacity-Building Practices	3. Families as Full Team Members
2. Family-Centered Practices	Transition Checklists
3. Family Engagement Practices	1. Hospital to Early Intervention
4. Informed Family Decision-Making	2. Early Intervention to Preschool
	3. Preschool to Kindergarten

(p. 5) for each early childhood intervention practice area. The complete set of checklists can be found at www.ectacenter.org/decrp/type-checklists.asp.

1.3.1. Assessment Practices Checklists

The Authentic Child Assessment Practices Checklist includes methods and strategies for observing child participation in everyday activities, the learning opportunities afforded a child in the activities, and identifying the person and environmental factors influencing child engagement and learning in the activities [23]. A main focus of authentic child assessment practices is identification of the child, adult, and setting factors that influence child engagement and learning in everyday activities [24] and the use of this information for planning and implementing interventions for promoting child learning and development [25].

The Building on Child Strengths Practices Checklist includes practice characteristics for identifying child behavior propensities that encourage and sustain child engagement in everyday learning activities and child competencies while involved in the activities [26,27]. The focus on child strengths (interests, preferences, abilities, etc.) is based on the fact that these particular behavior propensities influence child participation and engagement in everyday activities and contribute to functional child learning and development [28,29,30].

The Informed Clinical Reasoning Checklist includes methods and strategies for gathering information about child functioning in everyday activities and interactions with different people and materials for eligibility determination [31,32] or to determine which types of early childhood interventions are needed to promote child learning and development [23,33,34]. The terms clinical reasoning, informed opinion, and clinical judgment are often used interchangeably to describe either or both purposes [35,36,37].

The Engaging Families as Partners Assessment Checklist includes methods and strategies for involving parents and other family members in a child’s behavioral and developmental assessment and for planning functional interventions [38,39,40]. The checklist indicators focus on family members as unique and important sources of information for identifying which types of intervention practices are best suited for promoting child participation, engagement, and learning in everyday activities [41].

1.3.2. Environmental Practices Checklists

The Natural Learning Opportunities Checklist include practice indicators for using everyday activities as sources of child learning opportunities [42] and the adult behavior to both engage a child in the activities and to support and strengthen child learning while engaged in the activities [43]. The focus of the intervention practice is naturally occurring child learning opportunities [44] and responsive caregiving practices as an instructional strategy for supporting child learning [45].

The Child Physical Activity Checklist includes different kinds of activities for engaging children in physical movement and exercise [46]. The Environmental Arrangements Checklist includes practice indicators for ensuring indoor and outdoor spaces, equipment, and materials provide opportunities for active child play and physical movement [47]. The focus of both types of practices is promoting and improving child physical fitness and well-being [48].

The Assistive Technology Checklist includes practices for using different types of low tech (e.g., switch activated toys) and high tech (e.g., iPad) devices for promoting child participation in everyday learning activities [49]. The Environmental Adaptations Checklist includes practices for modifying or arranging the physical environment, scheduling, everyday activities, learning materials, instruction, etc. to support and promote child participation in social and nonsocial activities [50]. Both checklist practices are intended to reduce or eliminate barriers to participation in activities for promoting child learning and development [51,52].

1.3.3. Family-Focused Practices Checklists

The Family-Centered Practices Checklist includes the types of practitioner help giving practices for collaborating and interacting with family members in a competency-enhancing and strengths-based manner [53]. Family-centered practices include, but are not limited to, help giving behavior that treats family members with dignity and respect, informed family decision-making, nonjudgmental practitioner advice and guidance, recognizing and building on family strengths, and providing family members support and guidance as part of obtaining family-identified resources and supports.

The Informed Family Decision-Making Checklist includes methods and strategies for ensuring intervention plans and practices are responsive to family choices and priorities [54]. The Family Engagement Practices Checklist includes methods and strategies for both supporting and strengthening family capacity to be actively involved in obtaining family-identified supports and resources [55] or engaging parents and other family members in different kinds of intervention practices [53]. The two checklists include, respectively, relational and participatory help giving practices that, taken together, are the key characteristics of capacity-building family-centered practices [56,57].

The Family Capacity-Building Practices Checklist includes practice indicators for promoting, supporting, and strengthening parents’ use of everyday activities as sources of naturally occurring child learning opportunities in ways that facilitate not only child competence but also strengthen parenting competence and confidence [57,58]. The checklist practices are a particular type of participatory help giving specifically focusing on supporting and strengthening parents’ use of everyday activities for promoting child learning and development [53].

1.3.4. Instructional Practices Checklists

The three instructional practices checklists (Naturalistic Instruction, Embedded Instruction, Systematic Instruction) each include methods and strategies that practitioners, parents, and other primary caregivers can use to support and strengthen child acquisition of functional behavior in naturally occurring everyday activities or as part of planned instructional episodes; for example, [21,59,60]. The checklist practices include a number of instructional options for tailoring teaching strategies to the individual goals for and needs of different children [61,62,63]. The checklist indicators include, but are not limited to, the key characteristics of incidental teaching [64,65], milieu teaching [66], responsive teaching [67], and direct instruction [68].

1.3.5. Interactional Practices Checklists

The Adult-Child Interaction Checklist includes practice indicators for strengthening adult-child interactions [45,69] whereas the Child-Child Interaction Checklist includes practice indicators for promoting mutually interesting child interactions with friends or peers [70,71]. Both checklists emphasize adult contingent responsiveness [72,73] to child interactional behavior, the use of naturally occurring consequences for reinforcing child interactional behavior, and strategies for encouraging child behavior elaborations using modeling, imitation, expansions, scaffolding, and other instructional supports [22].

The Child Social-Emotional Competence Checklist and the Child Social-Communication Interaction Checklist both include adult interactional behavior indicators for supporting and strengthening, respectively, child social behavior in interactions with others [74,75] and a child’s ability to communicate effectively with others [72,76]. The practice indicators, however, are also applicable for promoting child play, cognitive, motor, and other behavioral and developmental outcomes [77,78,79,80].

1.3.6. Teaming and Collaboration Practices Checklists

These checklists include methods and strategies for improving team member communication and team functioning (Communication for Teaming and Collaboration Checklist), building effective teaming practices (Collaboration to Learn and Grow Checklist), and meaningfully involving family members on assessment and intervention teams (Families as Full Team Members Checklist). The checklist practices emphasize the knowledge and expertise of both practitioners and parents [38,81,82] and how sharing that knowledge and expertise can improve team functioning and intervention practices and outcomes [39,83,84].

1.3.7. Transition Practices Checklists

Young children with and without disabilities, medical conditions, or other “special needs” experience many different transitions between birth and elementary school [85,86]. The three transition checklists (Hospital to Early Intervention, Early Intervention to Preschool, Preschool to Kindergarten) each include methods and strategies for practitioners from both transitioning and receiving programs and agencies to use with children and families to ensure transitions are smooth and effective [86,87]. The checklists also include practices for ensuring transitions between programs and settings are done in ways that facilitate positive child and family adjustments and adaptations before, during, and after transitions; for example, [88,89,90].

2. Methodological Approach

2.1. Sources of Research Evidence

Findings from different types of research syntheses were the primary sources of evidence for the checklist practices. The meta-review described in this paper included the integration of findings in research syntheses of studies where results informed the selection or development of performance checklist indicators. Findings from individual empirical studies were used as evidence for checklist indicators when the results elucidated the relationship between practice indicators and outcomes of interest. Both the research syntheses and empirical studies were sourced from an EndNote library maintained by the author’s research institute identified through previously conducted controlled vocabulary, key word, and natural language search of multiple electronic databases (e.g., PSYCHInfo, ProQuest Central, Google Scholar).

Research findings were considered the foundations for checklist practices when and only when an intervention practice or one or more practice characteristics have been found to be empirically related to the intended outcomes of the practices. Accordingly, there needed to be a functional or statistical relationship between an independent or intervention variable and a dependent or outcome variable to claim that the checklist practice indicators were evidence-informed [91].

A functional relationship between an intervention practice and outcomes of interest is established by demonstrating that a change (improvement) on an outcome of interest is reliably associated with the introduction and continued use of an intervention practice; for example, [92]. A statistical relationship between an intervention practice and outcomes of interest is established by demonstrating that variations in the use of an intervention practice are reliably related to variations in the outcomes the intervention [93]. Both types of relationships are considered reliable when the practice-outcome relationships in different studies of the same or similar intervention practices have been replicated.

2.2. Types of Research Evidence

Two types of practice-outcome relationships were the focus of review and analysis. The first, which makes up the bulk of the evidence, was research on practitioner, parent, or other primary caregiver use of an intervention practice to affect changes in child, parent, parent-child, or family functioning. The second was research on instructor, trainer, coach, or others use of an implementation practice to promote practitioner, parent, or other primary caregiver use of an intervention practice. Figure 3 shows the relationships between these two types of practices; see especially [94] and different categories of outcomes. Intervention practices would be expected to be directly related to outcomes of interest, and implementation practices would be expected to be directly related to intervention practices. Implementation practices would also be expected to be indirectly related to outcomes of interest mediated by intervention practices. Mediated relationships were evaluated in research syntheses of studies investigating pathways of influence between different implementation and intervention practices and outcomes of interest using structural equation modeling or other type of path analysis; for example, [95,96,97,98,99,100].

2.3. Focus of the Meta-Review

The meta-review combines key features of both scoping reviews [101] and realist reviews [102]. Scoping reviews include broad-brushed compilations and analysis of research in one or more practice areas [103] that “aim to map the existing literature in a field of interest in terms of the volume, nature, and characteristics of primary research” [104] (p. 371). Realist reviews include a focus on explanatory analysis of practice-outcome relationships and the conditions under which those relationships have been replicated [105]. A meta-review extends the focus and goal of both scoping and realist reviews by examining the evidence for different kinds of practices reported primarily in research syntheses rather than in individual studies. Accordingly, a meta-review constitutes a synthesis of research syntheses with a focus on whether different types of integrative reviews provide reliable evidence for practice-outcome relationships.

Research syntheses include narrative reviews, best evidence reviews, critical reviews, systematic reviews, meta-analyses, and other types of integrative literature reviews that include an explicit focus on the relationships between an implementation or intervention practice and the intended outcome or benefit of a practice [106,107,108]. Practice-based research syntheses, when available for particular checklist practices, were the preferred sources of evidence because these types of research syntheses focus on unpacking and disentangling an implementation or intervention practice to identify the particular practice characteristics that “matter most” in terms of explaining outcomes of interest [109]. Those characteristics, in turn, are used as evidence-informed indicators for a checklist practice.

2.4. Scope of Evidence

The seven early childhood intervention practice areas each include a table with the sources of evidence for the checklist practices. The tables are included in Appendix A to Appendix G. Each source of evidence is coded as either a research synthesis (RS) or an efficacy or effectiveness study (ES). Each appendix also includes a column showing which sources of evidence are the research foundations for which particular checklist(s) (see Table 1). Research syntheses and empirical studies cited in the text are ones considered the best evidence for the checklist practices.

More than 200 research syntheses included evidence for the relationships between the checklist practices and the practice outcomes. Seventy-two percent of the syntheses were published in peer reviewed journals, 15% were published in books or book chapters, 6% were published as web-based publications pursuant to cooperative agreements with the U.S. Department of Education, and 7% were available through a number of other sources. Figure 4 shows the number of research syntheses for each practice area. The average number of syntheses for the seven practice areas was 32.29 (SD = 7.43). The number of syntheses per practice area ranged between 23 (transition practices) and 45 (environment practices). The average number of research syntheses for each of the 26 performance checklist practice areas was 8.74 (SD = 1.49). The average number of research syntheses for the performance checklists in each practice area ranged between 8 (transitions) and 12 (teaming).

2.5. Caveats

A number of caveats are mentioned to place the research evidence in empirical and practical context. First, the research evidence is illustrative and not exhaustive of the research foundations for the checklist practices. The particular research syntheses cited in the text are ones most germane to the purpose of this meta-review although all of the research syntheses and studies listed in the appendices include analyses of practice-outcome relationships. Second, certain seminal or other primary studies may not be listed on the tables because they are included in one or more research syntheses. Those studies include, but are not limited to, ones that have shaped and influenced our understanding of early childhood intervention practices. Third, some research syntheses included a mix of studies, some of which were investigations of practice-outcome relationships and some of which were descriptive or qualitative in nature. Descriptive or qualitative information that did not include examination of practice-outcome relationships were disregarded in this meta-review. Fourth, research syntheses published since the checklists were first developed and subsequently revised are not included on the tables but cited in the text when they include new evidence for the relationship between the checklist practices and intended practice outcomes. These research syntheses all contain analyses of implementation or intervention practices-outcome relationships. Fifth, quite a few research syntheses include evidence for two or more performance checklists and are listed in multiple tables in the appendices. This was not unexpected given the fact that so many performance checklists include interrelated characteristics of different early childhood implementation or intervention practices.

3. Findings

3.1. Assessment Practices

Appendix A includes the sources of evidence for the four assessment checklist practices (see Table 1). The majority of evidence is performance checklist specific or includes evidence for only two compatible checklists (e.g., authentic assessment practices and building on child strengths; authentic assessment practices and informed clinical opinion). The sources of evidence include findings primarily in research syntheses of studies investigating the relationships between the checklist practices and the intended outcomes of the practices. The types of evidence come from studies investigating the conditions under which the assessment practices are most effective; for example, [38,110,111], the differential effects of contrasting types of assessment-related practices; for example, [112,113,114], and the person and environmental factors associated with variations in assessment outcomes; for example, [30,115,116].

3.1.1. Authentic Child Assessment Practices

Macy and Bagnato [117] describe authentic assessment as the systematic observation and recording of child behavior in everyday activities by persons familiar with and knowledgeable about a child’s life. Dunst [24] added that authentic or ecological assessment practices should include identification of the person and setting factors that influence variations in child behavior and functioning in different everyday activities.

The research foundations for authentic child assessment practices include knowledge of the everyday activities, routines, and rituals that are the contexts for children to learn functional and culturally meaningful behavior [42,44,118,119] and the social and nonsocial factors that shape and influence acquisition of and variations in child behavior in those activities [100,119,120,121,122,123]. Everyday family, community, and preschool/child care life is made up of literally hundreds of different kinds of activities that are associated with context specific child behavior [42,119,124]. Participation in everyday activities, and its effects on child behavior, has been found to be associated with both naturally occurring events [115,125] and the intentional use of different types of activities to influence acquisition of child behavior [126,127,128].

Three sets of factors influence variations in child behavior in everyday activities: The characteristics of everyday activities experienced by a developing person, the behavior of other people in the settings, and the characteristics of the developing person himself or herself [129]. The characteristics of everyday activities that influence child behavior include, but are not limited to, activity type; for example, [127], material available to a child in the activities [130], activity organization [131], environmental arrangements [132,133], and adaptations to everyday activities (see Appendix B). The person factors that influence child participation in and behavior in everyday activities include the behavior of adults interacting with a child in everyday activities [134,135,136,137]. The person factors influencing child behavior also include, but are not limited to, the instructional practices (see Appendix D) and interactional behavior (see Appendix E) used by early childhood practitioners, parents, and other primary caregivers to shape and influence child acquisition of functional behavior.

The setting (activity) factors that influence child behavior in addition to those listed above include environmental arrangements (see Appendix B) that promote child participation in everyday activities and sustain engagement and learning in the activities; for example, [116,138,139,140,141]. The characteristics of everyday activities that invite and encourage child participation in interactions with the social and nonsocial environment are described as development-instigating factors whereas the behavioral consequences of these factors are described as development-enhancing factors [142,143]. Wachs’ [144] review of social and nonsocial factors influencing child learning indicates that multiple factors are related to variations in child behavior and development and that they affect child functioning in complex ways [145].

The child characteristics that influence behavior in everyday activities include, but are not limited to, the effects of children’s temperaments, etiologies, and severity of delays on learning and development; for example, [146,147,148,149,150] and children’s behavior propensities that encourage participation and sustained engagement in the activities (see Child Strengths-Based Practices below). The child characteristics that are the primary focus of authentic assessment practices are ones that can be manipulated as interventions or incorporated into interventions [151,152] whereas child factors such as type of disability or gender are examined in terms of their moderating effects; for example, [153,154]. The latter type of assessment practice has been found effective in terms of which intervention practices are most appropriate for children with different diagnoses and etiologies [155].

Authentic child assessment practices that focus on all of these different person and setting factors have been found to result in a better understanding of child behavior and functioning and the conditions under which child learning is most likely to be optimized [30,32,141,156,157]. Knowledge of the conditions under which child learning is optimized has proven especially informative for identifying child-specific everyday learning opportunities for promoting and strengthening child development [124,158,159] as well as the confidence and competence of persons engaging children in those activities [159,160].

3.1.2. Child Strengths-Based Practices

Two child-related factors that influence child engagement in everyday activities are children’s behavioral propensities and the social and nonsocial environmental factors that encourage and sustain child participation in the activities [120,161,162,163]. The research foundations for child strengths-based assessment and intervention practices include studies of either or both child-related factors influencing child learning and development.

The child-related factors that have been found to be particularly important are situational interests and child personal interests [27,164]. Situational interests include the interestingness of social and nonsocial environmental (setting) factors that evoke and sustain child engagement in everyday activities [165]. Personal interests include a child’s preferences, likes, favorites, etc. that motivate him or her to engage in desired activities or actions [166]. Both types of interests, and their effects on learning and development, are the research foundations for the child strengths-based practices checklist [121,167].

Findings in research syntheses of young children with and without disabilities indicate that both personal and situational interests are associated with a host of positive child behavior consequences [121,161,162,167,168]. Personal interests included child preferences, choices, and other individual characteristics that were indicators of things children liked, enjoyed doing, and positive affective responses (e.g., smiling, laughter, and general excitement). Situational interests included the novel and salient features of the social and nonsocial environment that evoked sustained attention and engagement. Comparative analyses of the two types of interests indicate that there are value-added benefits of personal interest-based child learning opportunities beyond those associated with situationally-interesting activities [162,168]. Both personal and situation interests are two factors influencing participation in everyday activities [120,136,169] and child learning while engaged in the activities; for example, [161,167,170,171].

A basic principle of strengths-based assessment and intervention practices is identifying and using existing and emerging child behavior as the building blocks for promoting child learning and development [26,163]. For example, this type of assessment and intervention has been used successfully to promote the response-contingent learning of young children with multiple disabilities and significant developmental delays; for example, [155,172,173]. As noted by Lancioni et al. [174], strengths-based practices are more likely to be effective because these practices do “not require excessive effort” (p. 271) on the part of a child to control environmental consequences compared to deficit-based practices that “require excessively high levels of effort” (p. 271) to produce environmental consequences.

In recently published papers in this particular type of research and practice, a strengths-based approach to early child contingency learning was found to have value-added benefits beyond those associated with a deficit-based approach to early child contingency learning [175,176]. The strengths-based intervention was found to be more efficient in terms of promoting child acquisition of response-contingent behavior compared to a deficit-based approach to intervention. Differences between two types of interventions favoring strengths-based practices were found on 5 out of 6 child learning measures. Findings from this line of research and practice also indicated that child contingency detection and awareness was associated with positive child social-emotional responding as an indication of a child’s recognition of the relationship between his or her behavior and the consequences of that behavior [75,177,178].

3.1.3. Informed Clinical Opinion Practices

Studies of informed clinical opinion include evidence for the conditions under which this assessment practice is most likely to be effective. Informed clinical opinions or judgments have been found to be effective for both early identification and eligibility determination [31,32,110,111,169] when the procedure (a) is guided by a formal set of assessment practices; (b) includes multiple sources of information from multiple informants; and (c) is guided by a consensus decision-making process [110,179]. Research syntheses for the teaming and collaboration practice (see Appendix F) also include evidence for the particular collaborative practices that contribute to accurate and reliable clinical decision-making [110,180].

Findings from a number of studies indicate that the use of available information about a child’s behavior based on observations, existing records, family member input, and other information results in decisions about eligibility for early intervention as ages earlier than those based on traditional, multidisciplinary assessment results [110,112,114]. Mott and Dunst [114], for example, found that informed opinion based on available information at the time of referral would have resulted in more than 75% of children being enrolled in early intervention at younger ages compared to using results from traditional, multidisciplinary assessments. Similar results were reported by Shernoff et al. [110] using an integrative consensus process for eligibility determination. These investigators found “that clinical judgment that is guided by well-articulated principles for distinguishing normative from problematic [child] behavior… holds promise as a systematic method for clinicians to collectively integrate different sources of data” for informed clinical decision making (p. 107).

An often overlooked characteristic of informed clinical opinion is the knowledge and expertise of the persons involved in using the assessment practice [181,182]. This includes the knowledge and skills of practitioners from different disciplines who use the practice [182,183,184,185,186] and the contributions of parents and other family members’ for informing assessment decisions [38,39,187]. Practitioners’ knowledge and skills include, but are not limited to, an understanding of normal and typical child development, atypical development and its effects on child behavior and learning, and the conditions under which early childhood intervention is needed and warranted [183,184,185]. These types of knowledge and skills are learned both in high quality professional development programs [188,189] and as a result of extensive experience that involves self-reflection or supervisor/peer facilitated practitioner reflection on assessment decisions and their consequences; for example, [190,191].

3.1.4. Engaging Families as Partner Practices

The research foundations for engaging parents and other family members in their child’s assessment include findings from research syntheses where meaningful family participation on assessment and evaluation teams is associated with better team decision-making and outcomes [39,111,180,187] as well as from studies demonstrating the value-added benefits of family participation on assessment teams [38,184]. Findings in these syntheses and studies add to our understanding of the methods and strategies for increasing family participation on assessment and intervention teams [39,184,187].

Meaningfully engaging family members on assessment teams has been found to be facilitated by a team member (e.g., service coordinator) who serves as a family advocate [84,192,193]. Engaging families as partners has also been found to be more effective when family-centered practices are used by the advocate and other team members to engage family members in their children’s assessments and interventions [187,194,195]. This is especially the case when a family advocate uses family-centered practices to support and engage parents and other family members in child and family assessment and intervention activities [193,196] (see Appendix C for other sources of evidence).

3.2. Environmental Practices

The research foundations for the five environmental practices are listed in Appendix B. The majority of evidence is from research syntheses; for example, [197,198,199,200] where findings from individual studies add to the knowledge base about which practice characteristics under which conditions are associated with intended practice outcomes; for example, [201,202,203]. Most of the evidence is specific to particular checklist practices whereas several research syntheses include evidence for two checklist practices [204,205,206].

3.2.1. Assistive Technology Practices

The types of assistive technology used with individuals with disabilities, including infants, toddlers, and preschoolers, continues to rapidly expand; compare, for example, Edyburn [207] vs. Edyburn [208]. Assistive technology for young children with disabilities includes devices such as switch operated toys, supported seating, powered wheelchairs, synthetic speech devices, adapted eating utensils, adapted computer keyboards, and other enabling devices [209,210,211]. Newer types of assistive technology include smart phones, tablet computers, and a host of different apps for facilitating child participation and learning [212,213,214,215,216].

There is a considerable amount of evidence that assistive technology can have a host of positive child outcomes [205,211,217,218,219,220,221] as well as have positive family benefits; for example, [198,222]. The child benefits include, but are not limited to, increased child participation in everyday social and nonsocial activities and improved child learning in the activities. The assistive technology-child benefit relationship has been reported in a number of research syntheses of studies of infants, toddlers, and preschoolers with different types of disabilities [211,216,217,220,221,223,224,225] as well as in research syntheses of studies including individuals with disabilities both younger and older than six years of age [220,221,226].

Despite the fact that different types of assistive technology have been found to be effective with young children with disabilities, there is evidence of non-use or abandonment of the devices by both parents and practitioners [203,227]. One factor often cited for nonuse or abandonment is the lack of adequate training in adults’ use of assistive technology devices with young children with disabilities [228,229]. Several reviews of assistive technology studies include reference to the fact that most investigators do not describe or even mention the provision of any type of training or professional development for using assistive technology [220,230,231].

Dunst and Hamby [205], in their meta-analysis of assistive technology studies of young children with disabilities, analyzed the relationship between type of training and parent and practitioner use of assistive technology devices as well as the relationship between type of training and child outcomes using Cohen’s d effect sizes as the metric for assessing the effects of the training on the study outcomes. Findings from a meta-analysis of adult learning practices were used to code and analyze six evidence-based characteristics of the training afforded the parents and practitioners in the technology studies [20]. Results showed that trainer use of a combination of 5 or 6 of the evidence-based adult learning characteristics were associated with the largest effects for the relationship between parent and practitioner use of assistive technology as well as child benefits. The majority of studies in the meta-analysis, however, employed less than half of the adult learning characteristics. This is at least one factor contributing to non-use or abandonment of assistive technology. The finding highlights the fact that there needs to be explicit attention to and use of evidence-based implementation (training) practices to ensure parent and practitioner use of assistive technology interventions with young children with disabilities or delays (see Figure 4).

3.2.2. Environmental Adaptation Practices

Adaptations involve modifications and changes to different aspects of the physical and social environment to enable child participation in the everyday activities and child learning while engaged in the activities [49,50,232]. This includes, but is not limited to, adaptations to everyday activities, environmental arrangements, activity flow and organization, materials available in the activities, and what adults do to promote and support child participation and learning in the activities [51,233,234]. Ǿstensjǿ et al. [203], in a study of 95 young children with cerebral palsy, the investigators found that the children’s parents made over 1000 environmental modifications to enable child participation in everyday activities where the different modifications had differential effects in terms of child participation and learning.

The research evidence for the effects of adaptations on child participation in everyday activities and child behavioral competence while engaged in the activities comes primarily from research syntheses of the effects of different types of adaptations on child participation and learning [200,205] and findings from studies investigating the effects of different types of training or coaching for promoting parents’ and practitioners’ use of the adaptations [203,235]. Findings reported in Trivette et al. [200] showed that adaptations to the environment, intervention activities, and intervention materials were associated with better child outcomes. Results reported in Dunst and Hamby [205] indicated that the use of evidence-based training procedures was related to parent and practitioner use of adaptations as well as positive child and adult outcomes.

3.2.3. Natural Learning Opportunity Practices

The sources of evidence for the natural learning environment practices include findings from research syntheses and studies of the relationships between participation in everyday activities and child learning [44,100,119,148,170,236,237,238,239,240] and research syntheses of the methods and strategies for increasing child participation in everyday activities [128,141,241]. The research foundations also include the sources of evidence for the instructional (see Appendix D) and interactional (see Appendix E) practices used to engage and reinforce child engagement and learning in everyday activities and the methods and strategies for promoting child participation in and acquisition of functional behavior and skills in those settings [59,242,243,244,245,246].

Findings from a number of studies indicate that different approaches to everyday child learning are associated with a different number of learning opportunities [118,247] and that contrasting approaches to intervention are differentially related to child and parent outcomes [237,238]. Results from these studies indicate that using everyday activities as sources of child learning opportunities results in more child learning opportunities compared to embedding traditional intervention practices in everyday activities. In addition, the child and parent benefits of using everyday activities as sources of child learning opportunities are far superior to those associated with implementing traditional intervention practices in everyday activities.

3.2.4. Physical Activity Practices

The research foundations for the two physical activity practices checklists (Child Physical Activity Checklist and Environmental Arrangements Checklist) include evidence about the types of interventions that have been found effective for engaging young children in active play, movement, exercise, and other physical activity; for example, [248,249,250,251,252,253,254] and both the naturally occurring; for example, [197,202,255] and planned; for example, Tremblay et al. [256] environmental arrangements that encourage children’s physical activity. Jansson [202] and Sugiyama et al. [255], for example, found that different features of indoor and outdoor spaces were associated with variations in child participation and engagement in everyday activities. Findings from research syntheses of the relationships between child physical activity and child behavioral outcomes; for example, Bower et al. [250], Ward et al. [254], Ahn and Fedews [257], Hinkley et al. [258] and interventions to increase child engagement in physical activity and exercise; for example, Brown et al. [204], Campbell and Hesketh [248], Kreichauf et al. [252] also include the research evidence for the child physical activity practices.

The sources of evidence for the two checklist practices include research evidence for how to arrange environments to encourage child engagement in physical activity; for example, Ǿstensjo et al. [235], Bower et al. [250], Fox [259], Schilmoeller and Amundrud [260] and establish the effects of and benefits from interventions to promote increased participation in activities; for example, [248,252,254]. The research evidence, taken together, indicates that different types of intervention practices have been found effective in terms of promoting child play, movement, exercise, and other physical activity; for example, Brown et al. [204], Gordon et al. [249], Bower et al. [250], Boldemann et al. [261] and that participation has a number of other kinds of positive child benefits; for example, Christian [197], Campbell et al. [248], Morgan et al. [253], Ahn and Fedewa [257], Hinkley et al. [258], Godbey [262].

A number of research syntheses include findings from studies of family-implemented interventions to engage young children in physical activity [204,263]. Results indicate that a number of different types of family activities are associated with positive physical exercise and movement. For example, parent and child engagement in mutually enjoyable physical activity was found to be a simple yet effective strategy for promoting child physical movement and exercise [204].

3.3. Family-Focused Practices

Appendix C includes the research evidence for the four family-focused intervention practices. The majority of evidence is from research syntheses of the relationships between different types of interrelated family-focused practices and child, parent-child, parent, and family outcomes; for example, [195,264,265,266,267,268]. The sources of evidence include results primarily from studies that have used measures of the key characteristics of the four checklist practices and outcomes of interest [53,57,195,265,269,270,271]. Findings from studies of the factor structure of the checklist practices indicate that each set of checklist characteristics measures separate but interrelated types of family-focused practices [53,270,271]. As a result, most research syntheses include evidence for 2 or 3 performance checklists and a few syntheses include evidence for all four checklist practices [56,267,272].

3.3.1. Family-Centered Practices

The foundations for family-centered practices include evidence for the relationships between relational and participatory family-centered help giving practices and a number of different child, parent-child, parent, and family outcomes [265,266,269]. Relational practices include, but are not limited to, complete and unbiased practitioner information sharing so that family members can make informed choices and decisions [53]. Participatory practices include, but are not limited to, methods and strategies for actively engaging family members in obtaining family-identified resources and supports [54] and for promoting parents’ use of different kinds of early childhood intervention practices for promoting child learning and development [53]. The two types of practices both include characteristics that operationally define a particular way of interacting with, treating, and involving parents and other family members in assessment and intervention practices that have capacity-building consequences [57,273].

Findings reported in a number of research syntheses indicate that the use of both relational and participatory practices are associated with more positive parent, parent-child, family, and child outcomes; see for example, [53]. Dunst et al. [266,267], for example, found in their research syntheses of family-centered practices studies that both types of practices are associated with parent satisfaction with practitioner help giving; parents’ self-efficacy beliefs; types and sources of family supports and resources; parent and family well-being; parenting competence, confidence, and enjoyment; parent and child interactions; and child behavior and functioning. Dempsey and Keen [269], in their recent review of the family-centered practices literature, identified five types of outcomes (parent satisfaction with a child’s development, parent stress and well-being, parenting capabilities, parent empowerment, and child development) that are associated with use of family-centered help giving practices.

Advances in our understanding of the effects of family-centered practices on child, parent, parent-child, and family outcomes indicate that in many cases the influences of these practices are indirect and mediated by other variables [53,269]. This was found to be the case in a number of structural equation and path analysis studies [97,99], meta-analyses [267,272] and meta-analytic structural equation modeling syntheses [274,275] of family-centered practices where the relationships between family-centered practices and parent well-being, parent-child interactions, and child behavior and development were indirect and mediated by parent personal beliefs and appraisals [276,277]. Results from the meta-analyses showed that family-centered practices were directly related to parents’ belief appraisals in terms of their abilities to influence practitioner and program responsiveness to their concerns and requests, and that family-centered practices were indirectly related to parent well-being, parenting confidence and competence, and child-functioning mediated by those belief appraisals. Results from the meta-analytic structural equation modeling research syntheses indicated that the effects of family-centered practices could be traced to variations in the parent-child interactions and child development mediated by both parents’ self-efficacy beliefs and well-being. The results from all the research syntheses and studies, taken together, indicate that family-centered practices are both directly and indirectly related to a number of outcomes germane to the goals of early childhood intervention.

3.3.2. Family Decision-Making and Engagement Practices

The evidence for both the informed decision making and family engagement practices include findings from research syntheses of the relationships between different kinds of informal and formal social support practices and child, parent, and family outcomes [187,195,278,279,280,281,282,283]. The social support practices constituting the focus of investigation include key characteristics of family systems [273] and family-centered intervention practices [280,284] and their relationships with parent and family functioning [195,264,281,283,285,286]. These include a focus of interventions on family identified sources and supports [279,287,288] and active family involvement in providing those sources of support and resources [57,187,278].

Findings from structural equation modeling and path analysis studies of the relationship between different types of family-focused practices and outcomes of interest indicate that the availability of social support and other resources are indirectly related to a number of child, parent, and family outcomes mediated by other variables [96,97,99,285,289,290]. In each of these studies investigators either reported mediated effects or some simple calculations of those effects indicated that the relationships between family-focused practices and outcomes of interest were indirect rather than direct. The mediated variables include, but were not limited to, parents’ belief appraisals (e.g., self-efficacy, optimism), parenting sense of confidence, and parent well-being depending on the particular outcomes that were the focus of analysis.

Findings reported in a meta-analytic structural equation modeling research synthesis indicated that effects of family-centered and family-systems intervention practices can be traced to variations in parents’ interactional styles and child development mediated by parents’ self-efficacy beliefs [275]. The family-systems practices included both informed family decision making and active family member engagement in obtaining both informal and formal sources of support and resources. The pattern of results was consistent with findings in other sources showing that the effects of family-focused practices on outcomes not the direct focus of family decision making and engagement are indirect rather than direct; see especially [53,269].

3.3.3. Family Capacity-Building Practices

The evidence for family capacity-building practices include findings from research syntheses of the relationships between different kinds of family-centered participatory practices and parenting confidence and competence [267,275] and research syntheses of relationship-based interventions specifically focused on supporting and strengthening parent-child interactions [291,292]. The research foundations for family capacity-building practices also include findings from studies of different kinds of practitioner intervention practices used to support and strengthen positive parenting practices [293,294,295].

As part of an applied research study using family capacity-building help giving practice to promote parents’ use of interest-based everyday activities for child language learning, the use of capacity-building practices by early childhood practitioners were related to both parents’ fidelity of use of the practices [296] and indirectly related to child language learning mediated by parents’ use of the interventions practices with fidelity [95]. Results from a number of research syntheses include evidence for similar pathways of influence [55,134,292,297]. The results, taken together, indicate that family capacity-building practices that support and reinforce parenting confidence and competence are important for parents’ use of practices strengthening parent-child relationships and promoting child learning and development [292,298].

3.4. Instructional Practices

The sources of evidence for the three instructional practices (embedded, naturalistic, and systematic) are listed in Appendix D. The three practices share common features and elements as well as have instructional practice specific characteristics. As a result, many of the research syntheses of the different instructional practices studies include evidence for two and even all three practices. This is especially the case for the naturalistic and embedded instructional practices which share quite a few key characteristics [21,299,300].

The three instructional practices each include explicit efforts to influence and reinforce child acquisition of functional behavior; for example, [301,302,303]. Each practice includes the use of verbal and nonverbal prompting strategies, contingent reinforcement of child behavioral competence, behavior shaping and elaboration strategies, modeling, prompt fading strategies, and other instructional techniques; for example, [63,304]. The practices differ primarily in terms of whether the teaching strategies are used to reinforce child-initiated behavior (naturalistic instruction) or promote child acquisition of adult selected behavior (systematic instruction).

The research foundations for the three instructional practices include the effects of different methods and strategies that parents or practitioners use to reinforce child behavior and facilitate acquisition of new competencies; for example, [21,59,63,242,303,305,306,307]. The research foundations also include evidence for the effects of arranging or manipulating antecedent events as conditions for instructional practices to have optimal benefits [132,308,309]. Nearly all research synthesis investigators concluded that use of the key characteristics of the instructional practices is associated with discernible child benefits [239,300,306,307]. The outcomes that are influenced by the instructional practices include, but are not limited to, child literacy, language, interaction, play, and social competencies.

The evidence for the instructional practices is primarily from research syntheses of studies investigating the effects of responsive teaching, embedded instruction, incidental teaching, milieu teaching, enhanced milieu teaching, and other related teaching methods, or the characteristics of the methods, associated with positive child effects [63]. The instructional practices, taken together, have been described as naturalistic instructional teaching or behavioral strategies [21,300].

A number of research synthesis investigators focused specifically on the effectiveness of teaching parents to use the instructional practices with their children; for example, [242,310,311,312,313]. Findings indicate that with practitioner support and guidance, parents learn to use the instructional practices with their children in ways having a host of positive child behavioral benefits. The same has been found to be the case for promoting preschool teacher and child care staff use of the different instructional practices [132,314].

The types of training afforded parents and practitioners to learn to use the instructional practices (as well as other practices) matters a great deal if the practices are used with fidelity and there is sustained use of the practices [314,315]. Dunst et al. [95,296], for example, found that practitioner use of an evidence-based adult learning procedure [316] was associated with parents’ use of intervention practices to increase child participation in interest-based everyday child language learning activities where responsive teaching was used to reinforce child language learning in the activities. Similar results were reported by Woods et al. [313] for using family-centered capacity-building practices for strengthening parents use of naturalistic instructional practices. Coaching and collaborative consultation are two implementation practices that have been found effective for promoting practitioner and parents’ use of different instructional practices; for example, [296,310,313,317,318].

3.5. Interactional Practices

Appendix E includes the research evidence for the interactional practices. Findings from studies in more than two dozen research syntheses indicate that an interrelated set of caregiver behaviors are related to variations in child competence; for example, [45,245,319,320,321,322,323,324,325]. These behavior include sensitivity to child behavioral cues, contingent social responsiveness to child behavior initiations, caregiver and child reciprocity and joint attention, and mutually enjoyable caregiver-child interactions [291,323,326]. The key characteristics of these practices, taken together, have been described as responsive parenting [45], responsive caregiving [327], developmental parenting [79], positive parenting [328], and relationship-based caregiving practices [292].

Caregiver use of the interactional behavior has been found to be nearly universal [320] although children from different cultural and ethnic backgrounds experience different amounts of the interactional behaviors [329]. The effects of the caregiving behaviors on child development, however, are similar regardless of cultural or ethnic backgrounds [329]. The effects of the interactional behaviors are also similar for children with or without disabilities or delays [239,326,328,330].

The particular behavioral and developmental consequences of the caregiver interactional behavior include, but are not limited to, child social-emotional competence [331], prelinguistic vocalizations [330] language development [239], cognitive development [291], and secure child attachment [323,325]. Although the bulk of evidence for the relationships between interactional practices and child outcomes are from studies of parents of young children, practitioner use of the practices are related in the same way to child outcomes; for example, [332,333,334].

Similar types of responsive caregiving behavior have been found effective for facilitating peer interactions of young children with and without disabilities or delays [132,308,335]. Bowman et al. [332], for example, found in their review of preschool teachers use of responsive caregiving practices that responsive caregiving was among a number of teaching strategies that enhanced positive peer interactions.

A number of different methods and strategies have been found effective for promoting caregivers’ use of responsive interactional practices [246,315,336,337,338]. Methods and strategies that focus specifically on facilitating adults’ awareness of children’s behavioral cues, accurate interpretation of those behavior, and sensitive and contingent social responsiveness to children’s behavior initiations, have been found to be most effective in terms of influencing child behavior; see especially [321,337].

These types of implementation practices have been found to be effective in terms of promoting practitioner and parents’ use of development-enhancing interactional practices; for example, [246,297,315,317,318,336,339,340]. The methods and strategies all include the use of capacity-building practices that have competency-enhancing characteristics and consequences [294,341].

3.6. Teaming Practices

Appendix F includes the research foundations for the teaming and collaboration practices. Most of the research evidence for the Collaboration to Learn and Grow Checklist practices and the Communication for Teaming and Collaboration Checklist practices are from the same research syntheses. The evidence includes findings from research syntheses of factors influencing team functioning and its consequences on team performance and effectiveness; for example, [342,343,344,345,346,347]. The research evidence also includes findings from research syntheses of studies of team leadership and how different types of leadership influence team collaboration, cohesion, and effectiveness; for example, [343,346,348,349,350,351].

The research evidence for family participation on assessment and intervention teams includes findings from studies demonstrating the benefits of meaningful family member involvement on teams; for example, [39,180,268,352,353] and the value-added benefits of using family-centered practices for promoting and supporting family-practitioner collaboration; for example, [268,354].

3.6.1. Team Communication and Collaboration Practices

Two of the most informative research syntheses specifically focused on identifying the key characteristics of effective teaming and collaboration [180,352]. Despite the fact that the research syntheses involved analyses of non-overlapping studies, there were remarkable similarities in terms of the particular characteristics of effective teaming. Nijhuis et al. [180] identified six key characteristics of effective teaming and collaboration, five of which had multiple salient elements. These included, but were not limited to, effective communication, shared problem-solving, collective goal setting, and shared team member responsibilities for intervention planning and implementation. The salient elements identified by Nijhuis et al. [180] as the key characteristics of effective teams were described by Mickan and Rodger [352] as the organizational and team processing characteristics contributing to team functioning and effectiveness.

Several key characteristics of effective teaming and collaboration stand out as particularly important as evidenced from the findings reported in research syntheses of teaming studies. The first is the role shared leadership plays in team functioning and how these leaders facilitate shared responsibility among team members [98,343,349,351,355]. A second key characteristic is the importance of team member knowledge and skills needed to make meaningful contributions to team processing and functioning [183,185,186,352]. Strauss et al. [184], for example, found the practitioner knowledge and skills not only contributed to improved shared team functioning, but also contributed to meaningful family member involvement in team processing and team decision making; see also [111].

Shared leadership stands out as particularly important for team cohesion, functioning, and performance; for example, [98,343,344,346,347,349,350,351,352,355]. Findings reported in these research syntheses indicate that shared leadership not only improves team cohesion and functioning but also improves shared responsibility and team effectiveness. Hoch [356], in her research syntheses of shared leadership, found that teams emphasizing information sharing as a focus of team functioning mediated the relationship between shared leadership and team performance and effectiveness. Team leadership that focused specifically on team member empowerment has been found to have the largest effect on team learning and effectiveness [355,357].

Both the Collaboration to Learn and Grow Checklist and Communication for Teaming and Collaboration Checklist include practices that focus on either or both interagency and intrateam collaboration as ways of improving team functioning and effectiveness; for example, [111,348,358,359,360,361,362]. Findings in a number of research syntheses indicate that interagency collaboration has positive benefits for programs, families, and children [348,359,360,361]. Foster-Fishman et al. [359] and Herlihy [360] found that effective interagency collaboration included shared values and goals; effective communication among interagency team members; and agency support for interagency collaboration, see also [358]. Similar types of characteristics have been identified as important for effective intrateam collaboration and functioning [111,347,362].

Team member training and team building have been the focus of a number of research syntheses and include evidence that different types of training can positively affect team building, cohesion, and communication [361,363,364,365,366]. Salas et al. [363], for example, found that different types of training improved team member performance when training focused on team member communication and shared decision-making. Klein et al. [364] found that team building that focused on improving interpersonal relationships, role clarification, shared goal setting, and shared problem solving were related to better team performance.

The use of adult learning methods and strategies for improving team functioning and performance has been found to be an important characteristic of the Collaboration to Learn and Grow Checklist practices. Results reported in the number of research syntheses indicate that team training that uses adult learning methods and strategies has value added benefits in terms of improving team performance and effectiveness [365,366,367].

Many of the characteristics of the two teaming and collaboration practices checklists have been found to be associated with positive learner outcomes in research syntheses of adult learning studies [20,368]. These include, but are not limited to, authentic team building experiences, multiple opportunities to engage in discussions and problem solving, peer coaching and mentoring, reflection on team processing, and shared decision making. The effects of the adult learning methods and strategies on learner outcomes have been found to be optimal when training is provided to a small number of adult learners [369]. Klein et al. [364], in a research synthesis of team building studies, also found that team building and training were more effective when done with a small number of team members.

3.6.2. Family Involvement Practices

Meaningful family member involvement on teams is a particularly important characteristic of effective teaming and collaboration [38,180,338,345]. Nijhuis et al. [180], as part of their research synthesis of teaming and collaboration, identified different dimensions of parent and family involvement as essential for optimal team functioning. These included, but were not limited to, family concerns and priorities as a focus of team functioning, explicit and intentional efforts to engage family members in team processing, use of family-centered practices to facilitate family involvement, and practitioner responsiveness to each family’s unique circumstances. All of this has been found to be accomplished by a team member serving as a family advocate who represents the best interest of the family and individual family members participating in team decision making [38,39].

A number of research syntheses include evidence indicating that practitioners who engage family members on teams in a family-centered manner results in more active family member participation in both assessment and intervention practices; for example, [39,194,268,353]. The characteristics of family-centered practices that support family member involvement include, but are not limited to, sensitivity and responsiveness to family concerns and priorities, complete and unbiased information sharing so family members can make informed decisions, active family member participation in teaming activities, and explicit and authentic practitioner efforts to treat family members as equal partners in all aspects of teaming practices [53,370].

In a recent review of the family-centered practices literature, Rodger and Keen [371] noted that shared decision-making between families and practitioners improved both the provision of child and family services and the outcomes of those services; see also [372]. Family member participation in shared decision-making on assessment and intervention teams includes, but is not limited to, complete and unbiased information sharing so families can make informed decisions [111,180,184,360].

3.7. Transition Practices

Research evidence for smooth and effective transitions from hospital to home/early intervention, early intervention to preschool/preschool special education, and preschool to kindergarten/elementary school are listed in Appendix G. The same or similar types of practices for different types of child and family transitions have been found to be important for ensuring smooth and effective transitions although most research has focused on particular transition periods (e.g., hospital to home).

Converging evidence from research syntheses of transition studies point to a number of conditions that contribute to successful transitions. These conditions include transition planning between both transitioning and receiving program practitioners, parent and family involvement in transition planning and implementation, explicit attention to the types of transition experiences promoting continuity in children’s learning and development, and use of family-centered practices to reduce parent stress and promote positive child and family adaptations and adjustment prior to, during, and following a transition; for example, [373,374,375,376,377,378,379,380,381,382].

There is evidence that transitions are best understood and facilitated in the context of an ecological framework [87,374,383] that explicitly considers the interrelationships between individuals and programs/agencies involved in transitions and how those relationships promote or impede successful transitions [374,377,380]. As noted by Odom and Wolery [384], attention to these relationships and ecological influences are “enhanced by a developmentally instigative adult” (p. 166) who “promotes the continuity of experiences across settings [to] ideally create a seamless service system” transition (p. 169). The complexity of these relationships was reported by both Affleck et al. [88,378] and Williams and Williams [385] in studies of variables associated with effective and ineffective transition practices. Affleck et al. [88], for example, found in a hospital to home transition study that support provided by home visitors in response to mothers indicating a need for assistance had positive effects on mothers’ adaptations and adjustments to home care of high risk infants. In contrast, unsolicited assistance (help) had negative effects on these same outcomes; see also [386,387,388].

A number of research syntheses and studies include evidence for the use of family-centered transition practices to increase the likelihood that transitions are smooth and effective [192,379,382]. Family-centered practices have been found to be related not only to smoother transitions between transitioning and receiving programs but are also related to more positive child and family outcomes and especially less stress and better adaptations and adjustments before, during, and following transitions.

Findings in a number of research syntheses of outreach practices to facilitate referrals to receiving programs indicate that more frequent outreach that is brief and highly focused improves referrals from transitioning programs and practitioners [389,390]. The particular outreach practices that have been found to be most effective were used by Dunst et al. [391] to increase referrals from neonatal intensive care units to early intervention. Results showed that brief, repeated contacts with hospital staff were more effective in terms of increased referrals compared to less frequent contacts.

Interagency agreements have been found to be at least one way to facilitate smooth transitions between programs and agencies [392,393,394]. Herlihy [360], in a review of the characteristics of effective interagency collaboration, identified open and effective communication, positive interpersonal relationships, and shared goals as important for collaboration to have positive consequences. Results reported in a study by Hadden [392] found that these characteristics as well as several others (e.g., review and monitoring of interagency agreements) were related to successful transitions from early intervention to preschool programs.

4. Discussion and Conclusions

4.1. Summary of the Findings

Early childhood intervention has a relatively short but rich history [395,396]. Contemporary interest in early childhood intervention can be traced to the 1960s and 1970s [397]. In the 50+ years since early childhood intervention was recognized as a factor that could be used to alter the course of development of young children with disabilities or delays, considerable advances have been made in terms of our understanding of the kinds of experiences having optimal developmental benefits and the research evidence for those practice-outcome relationships [14,397,398,399].

This paper included a description of 26 early childhood intervention performance checklists and the research evidence for the checklist practices. Findings reported in more than 200 research syntheses informed the selection or development of the checklist practice indicators based on the empirical relationships between the checklist indicators and the intended outcomes and benefits of the practices. The meta-review constitutes one of the most comprehensive analyses of the early childhood intervention research literature focusing on the performance checklist practices.

The performance checklists were initially developed using the Division for Early Childhood [16] early intervention/early childhood special education recommended practices as the sources of practice indicators [11]. It was determined, however, that the DEC recommended practices differed considerably in their formatting, coverage, specificity, and internal coherence, and that the ways in which many of the practices are written, essentially made attempts to infer intent futile. This, to a large degree, was the basis for developing the performance checklists.

There was one other factor influencing the development of the performance checklists and compilation of the evidence for the checklist practices. As part of the development of the DEC recommended practices, a Recommended Practices Commission (2015) submitted sources of information as evidence for the practices despite the fact that “Given the accelerated timelines for producing a revised set of recommended practices…, the commission determined it would not be feasible to conduct comprehensive literature reviews to gather information about the status of best-available evidence” [400] (p. 21). A review of the source of evidence provided by the commission for the recommended practices found that in many cases the sources did not include the kind of information to claim the practices were evidence-based. A review of that information by the author found most of the literature did not include practice-outcome data, many of the studies cited as evidence for the recommended practices actually included evidence for other types of intervention practices, and literature was often cited with no rhyme or reason for why it was included as sources of evidence for the recommended practices.

Claims that any intervention practice is evidence-based or evidence-informed necessitates that there is research cited for practice-outcome relationships. Comparatively speaking, the evidence base for the performance checklists is substantial in scope and content, whereas the evidence for the DEC recommended practices at the time the practices were released, at least as compiled for some practice areas, is weak at best.

The type of analysis described in this paper is best described as a meta-review of practice-outcome evidence for a collection of early childhood intervention practices. Haneef [107] described this type of synthesis as “empirical research consolidation” (p. 383) where the focus of analyses are studies of the functional or statistical relationships between different independent or intervention variables and different dependent or outcome variables in order to aggregate evidence from diverse sources, to draw conclusions, and make interpretive statements about the strength of the empirical evidence. For each and every performance checklist, multiple research syntheses included different sets of research evidence where practice-outcome relationships were the same or very similar, providing converging evidence indicating that the checklist indicators have substantial evidence bases.

4.2. Strengths and Limitations

The meta-review has both strengths and limitations. One strength is the fact that different bodies of evidence for different early childhood intervention practices have for the first time been compiled in one place. This should prove useful for practitioners to be able to cite relevant findings for different practices, and especially in the current era of calls for the use of only evidence-based interventions; for example, [401]. A second strength is the breadth of evidence that was compiled for each performance checklist practice. Even a cursory search for additional evidence for the practices unearths more recently published research syntheses and studies for the checklist practice indicators. Yet another strength is the categorization of the research evidence for individual checklist practices (Appendix A–Appendix G). This permits easy identification of which sources of evidence are the foundations for which practices.

The meta-review also has a number of limitations. One limitation is the fact that the meta-review did not permit in-depth analysis of the studies in each research synthesis given the number of syntheses and the number of performance checklists. If the necessary fiscal and human resources were available, either a systematic review [106] or meta-analysis [402] of the individual studies in the research syntheses might have yielded more specific information about practice-outcome relationships. A second limitation is the fact that research syntheses for individual checklist practices varied in terms of the depth of analysis in the synthesis reports. This was addressed in the meta-review by highlighting particular syntheses that included the best evidence for the checklist practices. A third limitation is the fact that certain practice areas, and checklist practices in the different areas, had substantial amounts of evidence (e.g., interactional practices) while other areas had considerably less evidence (e.g., transitions). This was most likely the case simply because certain practices are more likely to be viewed as worthy of research attention.

Both the strengths and limitations of the meta-review place the research evidence for the performance checklists in empirical and practical context. The strengths highlight the breadth of the research foundations for the performance checklists. The limitations highlight gaps in the knowledge base for the practices.

4.3. Conclusions

Early childhood intervention that is evidence-informed is more likely to have positive child, parent, and family outcomes and benefits. Performance checklists (as well as other intervention tools) informed by research evidence hold special promise for improving early childhood intervention practices. The checklists that were the focus of this paper were found to have a substantial evidence base. The evidence base included the particular practices and indicators that are associated with outcomes of interest. The practices and indicators in turn informed the selection and development of the checklist items. The extent to which the items are used with fidelity should therefore ensure or at least increase the likelihood that the checklist practices mirror their research foundations and have expected benefits and outcomes; for example, [94,403,404].