Infants in a public school system: the indicators of early health and educational need.

The Brookline Early Education Project (BEEP) is a demonstration model in which a public school system in collaboration with a pediatric center has extended teaching and diagnostic services to the earliest days of life. In most cases, enrollment and data collection began three months before the children were born. A comprehensive diagnostic component including health, neurologic, sensory, developmental, and psychological assessments was performed periodically. The present study, the first of several reports, is an analysis of positive indicators of health and developmental need during the first six months of life. At the time of initial surveillance, age 2 weeks, a high yield of physical and demographic findings, along with perinatal stresses, was observed. It was noted that demographic, neurologic, physical, and perinatal stress factors appeared as independent variables. At the three- and six-month checkpoints, there were more overlapping findings between the categories of physical assessment, developmental examination, and neurologic evaluation. Over the six-month period, there was a tendency toward instability of findings: The group of youngsters thought to have special needs at the age of 2 weeks, 3 months, and 6 months differed in composition from each other. Likewise, there was significant flux in membership between the three- and six-month groups with needs. The study may have public policy implications, insofar as early education services should not be constructed to admit only "high-risk newborns" since this would exclude many children whose needs would become manifest later and would take in a number of children falsely identified as in need but with the resiliency to overcome this. The BEEP program has relevance for pediatric practice in demonstrating a component of health care with greater diagnostic and therapeutic responsibility for educational competence in young children.