Effects of Different Types of Adaptations on the Behavior of Young Children with Disabilities

The effectiveness of adaptations to the en- vironment, materials, and activities with young chil- dren with disabilities was the focus of this research synthesis. The synthesis included 19 studies of 104 children with different types of disabilities (autism, multiple disabilities, developmental delays, Down syndrome, visual impairments, cerebral palsy, and behavioral disorders). Most of the studies used single participant designs; two studies used contrasting con- ditions designs, two investigations were case studies, and one was a cross-sectional study. Results showed that all three types of adaptations were related to variations or changes in child behavior; the adapta- tions were most effective when used for 10 or more sessions; and the outcomes most effected by the in- terventions were communication and cognition, and to a lesser degree, social behavior. Implications for practice are described. This paper includes a research synthesis of findings from studies of young children with disabili- ties where different types of adaptations were used to promote child participation in typically occurring ac- tivities to affect the behavioral competence of the children. The adaptations included both environ- mental accommodations and modifications to activi- ties and materials (e.g., Bailey & Wolery, 1992; Camp- bell, Milbourne, & Wilcox, 2008; Doctoroff, 2001; Mayfield, 1996; McCormick & Feeney, 1995; Sandall, 2003). Environmental adaptations include such things as rearranging play areas in classroom settings and rearranging furniture in a child's home to make it eas- ier for a child to move around. Adaptations to activi- ties include such things as making modifications to curricular activities and simplifying an activity by breaking it down into a smaller number of steps so that a child can more easily complete a task. Adapta- tions to materials include such things as putting han- dles on puzzle pieces and having a child use specially designed eating utensils to make it easier for a child to use the materials. It is generally agreed that adapta- tions make possible child participation in classroom, home, and community settings, and that participation in turn provides the contexts for child learning (e.g., Hamm, Mistrett, & Ruffino, 2006; Mistrett, 2004; Os- tensjo, Carlberg, & Vollestad, 2003; Wolery, Schroe- der, Martin, Venn, Holcombe, Brookfield, Huffman, & Fleming, 1994). The extent to which the use of adaptations were associated with discernable differ- ences in child behavior and competence was the main focus of this research synthesis. The research synthesis was guided by a char- acteristics--consequences framework that focused on how and in what manner different types of adapta- tions had similar or different effects and conse- quences (Dunst & Trivette, 2009; Dunst, Trivette, & Cutspec, 2007; Dunst, Trivette, & Watson, 2009). More specifically, we examined the conditions under which different types of adaptations affected young children with disabilities' cognitive, communication, social, and motor behavior. The studies included in the synthesis were ones where the adaptations were the primary or sole intervention and child behavioral competence was an outcome of interest. The investi- gators of all the studies included in the research syn- thesis hypothesized or predicted that the adaptations would be associated with discernable behavior conse- quences.