opmental disabilities, the promotion of competence in normative community contexts is particularly important as a vehicle for both acquiring functional skills and gaining social acceptance (Guralnick, in press).
The evolving nature and imprecise measurement of the concepts of “coordinated,” “community-based,” and “family-centered” underscore the critical need for more descriptive, exploratory investigations in this area, including both qualitative and quantitative research. Indeed, as described in Chapter 4, the level of maturation of the knowledge in this area indicates that experimental, randomized studies would be premature and of less value at the current time.
As the concept of early childhood intervention continues to evolve, it faces a multitude of ongoing challenges. Some must await the generation of new knowledge; others will depend on the resolution of old political conflicts. In the final analysis, the future vitality of the field will be served best by a creative blend of critical self-evaluation and openness to fresh thinking. The following seven challenges are particularly important at this point in time: (1) increasing access and participation, (2) ensuring greater quality control, (3) defining and achieving cultural competence, (4) identifying and responding to the special needs of distinctive subgroups, (5) influencing and evaluating the impacts of postintervention environments, (6) strengthening the service infrastructure, and (7) assessing the costs of early childhood investments.
Marked inequalities in access to state-of-the-art early childhood services are a serious problem. Diminished accessibility is related to a variety of potential barriers, including cost, language, culture, citizenship status, transportation, eligibility standards, program scheduling, and stigma associated with labeling, among others.
Beyond the failure of existing policies and programs to ensure the identification and enrollment of all children and families who could benefit from available services, many early childhood intervention efforts experience significant participant attrition. For example, in one study of ParentChild Development Centers, 47 percent of the treatment group dropped out in the first year of the program (Walker et al., 1995). Of the 985 children enrolled in the Infant Health and Development Program, 81 received no services whatsoever (Liaw et al., 1995). Average attendance in the High/Scope Perry Preschool Program was 69 percent in the center-based component (Weikart and Schweinhart, 1992), and only 56 percent of the families