Lighting a Spark In the Mind of a Child
By Ellen Sullivan
Reprinted with permission from UAB Arts & Sciences Magazine
Vol. 1, No. 1, UAB Office of Public Relations and Marketing
(Article has been reformatted for web page publication)
As University Professor in Psychology and Director of UAB’s Civitan International Research Center, a multidisciplinary center concerned with human development— especially the treatment and prevention of disabilities that begin in childhood—Craig T. Ramey, Ph.D., has become deeply involved in the study of young children at risk for mental retardation.
“Mental retardation is a relative concept,” Ramey is quick to point out. “One is judged mentally retarded if one’s performance falls below clinically set cutoff points for cognitive performance and the ability to function in the everyday world.
“For example, if your IQ is below 70, you have difficulty adjusting to school and the work is hard for you because of limited cognitive skills, you will be labeled mentally retarded. That label is important in this country and most others, because it’s a prerequisite to getting additional services. If a child is labeled mentally retarded in preschool, he is eligible for early intervention. After the age of three, the same child is eligible under federal law for ‘free and appropriate public education’ delivered via public schools.”
Early Intervention Is Key
The rub, according to Ramey, lies in gathering evidence that the effectiveness of treatment for mental retardation is likely to be much higher if intervention begins early. In fact, Ramey’s research indicates that if most kids who have been labeled mentally retarded could have been identified earlier, and given appropriate services, their prognoses might have been considerably improved. In fact, they might never have been labeled mentally retarded at all.
“The public is behind the times in thinking of mental retardation as only a genetic defect or an irreversible condition that can’t be treated once it happens. This is simply not true. Seventy to 80 percent of cases have a substantial experiential component. In other words, if the right experiences can be provided to the child early enough in his or her life, the retardation label is avoidable. The exact way in which these early experiences work is not clearly understood. But we do understand how to provide them.”
Identifying At-Risk Children
Ramey has conducted dozens of research programs, including several currently under way, that point directly to the avoidance of what society calls retardation. He starts by identifying children at risk. Typical risk factors: The child is from a poor, undereducated family; the child has a low birth weight; the child is premature; the child is slightly developmentally delayed but not enough—yet—to be labeled mentally retarded. (Ramey is a strong proponent of building such risk factors into early childhood screening programs in medical evaluations, preschool, and other community venues.)
Ramey’s most recent research project involves about 2,000 Alabama children—all of those in early intervention programs—in an effort to understand whether these programs can be improved. In addition, Ramey and his research team are conducting a nationwide, eight-site study involving about 1,200 children.
Ramey and fellow researchers are also involved in a multisite—with UAB serving as the primary site—30-state study, involving 12,000 children and their families. This study explores whether children can better adjustment to school by engaging in stimulating hands-on learning activities. Teaching colors and shapes through activities such as cooking, for example, prepares children for more formal learning settings later on.
UAB Tackles Large Problems
The typical parental participant in a Ramey study is a new mother, still in the hospital, having just given birth to a low-birthweight, premature baby. If the mother agrees to participate in a new study, she is carefully informed that it will consist of two groups. One group will experience a “treatment condition,” the other a “comparison condition.” In other words, based on a random drawing, the mother will be invited to join one or the other group.
Ramey emphasizes that in studies conducted at UAB, “We always give more services than the family would get if they didn’t participate. This way the child will always receive a greater benefit than he would if his family did not take part in the study; also, you get a much more powerful research vehicle when you test different types of treatments against each other.”
Families Explore Options
In the most intensively treated group, the mother and child are provided with infant formula, if the mother uses formula for feeding. The child receives free medical care. Each family is visited by a specially trained home nurse or social worker once a week to discuss issues of family life and to hear suggestions about how to use the resources available in that community.
When the child is one year old, he or she is enrolled in a special child development center for at least half a day every weekday. Parents are encouraged to come in and visit frequently.
In addition, professionals are made available to the family to help them think through their current circumstances and, perhaps, improve them. If a parent wants to go back to school or undertake job retraining, there’s someone available to help them explore the options.
These aspects of the program continue until the child is three years old. After that, each encounter with the child by a member of the study team continues to be documented in detail: 27 different areas of the child’s development are monitored simultaneously. All available health care and developmental therapies are provided as the child matures. One Ramey study has tracked the cognitive development of participating children to the age of 21.
In talking with Ramey, it’s impossible not to agree that there’s no reason every child, everywhere, shouldn’t have access to the experiences that will help him or her flourish into a fully realized individual.
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