(1990) reported that such programs improved the developmental outcomes of low-birthweight and premature infants. Infants from one to three years old who were assigned to the intervention, which included attending a child development center five days a week, showed improved IQ scores.

Positive effects from these programs are possible if they are adequately funded and staffed with well-trained, competent teachers (U.S. Department of Health and Human Services, 1985; Schweinhart and Weikart, 1986).

Head Start and comprehensive day care programs have been shown to be effective interventions in reducing the incidence of school failure. Early educational interventions should continue to be implemented but should be evaluated further.

Community Educational Priorities

Communities can promote prevention in a broad variety of settings, such as clinics in public schools. Community leaders also have successfully used public school curricula, newspapers and other media, churches, and the business sector to promote information in priority areas. Health promotion and disease prevention education should be an integral part of the curriculum in public schools and should include the rationale for preventive measures such as immunization and newborn metabolic screening.

Recent efforts to evaluate the effectiveness of school-based health education will enhance the quality of the prevention science base (Kolbe, 1986), and the National Cancer Institute's program to assess the impact of school curricula on student health behavior provides a useful model for evaluating prevention in the developmental disabilities area. In addition, several of the Health Objectives for the Year 2000 (U.S. Department of Health and Human Services, 1990) focus on increasing instruction in specific prevention activities. Many of these objectives are relevant to developmental disabilities prevention.

The effectiveness of school-based programs in health education should be reviewed and improved as necessary to educate children about prevention including the prevention of disability.

Access to Public Education

Landmark 1975 legislation (P.L. 94-142) mandated the education of children with disabilities in the least restrictive environments and required the provision of special education services to make school completion possible. Although there is considerable variability in placement policies among school districts, on average, 27 percent of ''students with handicaps" were placed



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