Purpose: Children with a history of prenatal alcohol exposure or Fetal Alcohol Spectrum Disorders exhibit early signs of developmental delays that are manifested in a host of neurocognitive, behavioral, and social problems throughout life including major obstacles to success in school. These children show deficits in language comprehension, reading, spelling, and math; are at increased risk for learning disabilities and problematic classroom behaviors; and are likely to require special education services. The purpose of this project is to develop an intervention, Strategies to Enhance Early Developmental Success for School Readiness, that can be used with preschools to promote school readiness and positive school outcomes for children with Fetal Alcohol Spectrum Disorders. The proposed intervention will provide center-based, child-focused instruction intended to improve self-regulation, socioemotional competence, and early literacy and numeracy skills. Additionally, this intervention will provide programs to equip parents with strategies for promoting school readiness skills at home and for collaborating with school personnel.

Project Activities: Approximately 40 3- to 5-year-old children will participate in this research. The children will meet criteria for Fetal Alcohol Spectrum Disorders, Partial Fetal Alcohol Spectrum Disorders, or Alcohol-Related Neurodevelopmental Disorder. During the first phase of development, multiple stakeholders will provide input on the intervention components and an initial version of the intervention. During Phase 2, Strategies to Enhance Early Developmental Success for School Readiness will be implemented in a pilot study with families. The intervention will be modified based on findings from Phase 2. The revised intervention will be implemented in Phase 3. Another pilot study will determine whether children's school readiness skills showed improvement after receiving the intervention. Data will be analyzed to determine whether Strategies to Enhance Early Developmental Success for School Readiness improves children's self-regulation, socioemotional competence, and early literacy and numeracy skills. Data will also be analyzed to determine whether parents show increases in parental efficacy and knowledge about Fetal Alcohol Spectrum Disorders as well as decreases in parental stress.

Products: The products of this project will be a fully developed intervention, Strategies to Enhance Early Developmental Success for School Readiness, designed to improve the self-regulation, socioemotional, and early literacy and numeracy skills of young children with Fetal Alcohol Spectrum Disorders. Published reports describing its promise for improving outcomes will also be released.

Structured Abstract

Setting: For the purposes of this development project, the research will take place in university outpatient mental health settings in California.

Sample: Approximately 40 children from 3 to 5 years of age will participate in this research. The children will meet criteria for Fetal Alcohol Spectrum Disorders, Partial Fetal Alcohol Spectrum Disorders, or Alcohol-Related Neurodevelopmental Disorder.

Intervention: The proposed intervention will be designed to improve self-regulation, socioemotional competence, and early literacy and numeracy skills. The intervention will consist of child and parent groups that run concurrently and have related content. The child groups will meet for 3-hour sessions, two times per week over the course of 15 weeks. Approximately 10 children will participate in each group. The groups will be facilitated by two group leaders and two assistants to allow for large group, small group, and individualized instruction. The group activities will include free play, structured facilitator-guided activities, snack time, and bathroom time. The intervention will be divided into three 5-week thematic blocks, with blocks organized around a particular theme such as family and community or safety. Parent groups will meet weekly and focus on teaching parents how to promote school readiness skills at home and advocate for their children.

Research Design and Methods: The development of Strategies to Enhance Early Developmental Success for School Readiness will proceed in three phrases. During the first phase, multiple stakeholders—including parents, service providers, and researchers—will provide input on the intervention components and an initial version of the intervention. During Phase 2, Strategies to Enhance Early Developmental Success for School Readiness will be implemented in a pilot study with two groups of families. Observational data will be collected to determine fidelity of implementation. In addition, group facilitators will provide feedback after each session. The intervention will be modified based on findings from Phase 2. The revised Strategies to Enhance Early Developmental Success for School Readiness will be implemented in Phase 3. A quasi-experimental design using a waitlist-control group is planned to determine the promise of the intervention for improving children's school readiness skills.

Control Condition: A waitlist-control condition is planned for Phase 3. Until they are provided the Strategies to Enhance Early Developmental Success for School Readiness intervention, children in this control condition will receive the intervention and services that they typically receive in community or early childhood special education programs.

Key Measures: Two types of data will be collected to inform the development of Strategies to Enhance Early Developmental Success for School Readiness—process data and child assessment data. The research team will complete observations of activities for every session, and focus groups will be held with parents and service providers to elicit feedback regarding the groups and session materials. Parents will report on their children's behavior as well as perceptions of their own competence and stress. The team will also administer measures of children's emotional understanding, executive functioning, and early literacy and numeracy skills before and immediately after the intervention.

Data Analytic Strategy: A general linear mixed model series of data analytic strategies will be used to determine whether Strategies to Enhance Early Developmental Success for School Readiness shows promise for improving children's self-regulation, socioemotional competence, and early literacy and numeracy skills. Data will also be analyzed to determine whether parents show increases in parental efficacy and knowledge about Fetal Alcohol Spectrum Disorders as well as decreases in parental stress.