LSHSS

Clinical Forum

Understanding Curriculum
Modifications and Embedded Learning
Opportunities in the Context of
Supporting All Childrens Success
Eva Horn
University of KansasLawrence

Rashida Banerjee
University of Northern ColoradoGreeley

oth the Individuals With Disabilities Education

Act ( IDEA) Amendments of 1997 and IDEA 2004
address access to the general education curriculum in
the provision of educational services for children and youth with
disabilities. A key feature of the concept of access, as described in
IDEA, Part B regulation, is the phrase participation and progress
in the general curriculum (Federal Register, 2006). Specifically,
IDEA contains statutory language requiring that each students individualized education program ( IEP) include a statement describing how the childs disabilities affect the childs involvement with

and progress in the general curriculum; the measurable goals that

will be set in order to enable the child to be involved with and progress in the general curriculum; and the services, program modifications, and supports necessary for the child to be involved in and
progress in the general curriculum. It is clear from reading the statute
and regulations that the intent of the mandate is to ask educators
to raise their expectations about learning outcomes by providing a
more challenging curriculum for students with disabilities and to
be more accountable for students achieving meaningful outcomes
(Agran, Alper, & Wehmeyer, 2002; Nolet & McLaughlin, 2000).

ABSTRACT: Purpose: The primary purpose of this article is to

provide a closer look at the individualization process whereby
early childhood professionals ensure that the individualized
learning priorities for each child are appropriately addressed.
Method: Early childhood professionals, including speechlanguage pathologists (SLPs), are working to meet the federal
mandate of access to and progress in the general curriculum
for children with disabilities. A promising approach to achieving
this mandate is a multitiered model of support that has as its
foundation a high-quality, universally designed curriculum.
Following a brief description of the components of this model, the
discussion shifts to a focus on the individualization components.
Childrens individualized needs for supports are provided through

instructional individualization, including curriculum modifications and embedded learning opportunities.

Implications: Implementation of a multitiered model of support
has direct implications for the SLP working in preschool settings.
The decision for when and what form the supports should take
is determined through assessment and by linking desired child
outcomes to curriculum content and the individualized child
supports. In order to be an effective team member in this process,
the SLP must understand the concepts and specific strategies that
form the foundation for each tier.

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KEY WORDS: individualization, access to general curriculum,

universal design for learning, embedded learning opportunities

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0161-1461/09/4004-0406

Further evidence for the call for greater accountability for students
achieving meaningful outcomes is provided by the Office of Special
Education Programs requirement in 2005 that states, in its annual
report on implementation of IDEA, that every state must submit
outcomes data for all children served through Part C and Part B
preschool programs between when they begin either Part C or Part B
preschool services and when they exit the program (Hebbeler,
Barton, & Mallik, 2007).
Meeting the mandate of access to the general curriculum
and documentation of child progress on federal child outcomes
requires educators and related services professionals, such as
speech-language pathologists (SLPs), not only to help the child
with special needs be in the general education classroom and
participate in the activities, but also to ensure that each child learns
the important curriculum content that is offered to all children in
early education programs (Kameenui & Simmons, 1999; Nolet &
McLaughlin, 2005; Simmons, Kuykendall, King, Cornachione, &
Kameenui, 2000). Converging empirical evidence has identified
key components of effective practices for supporting access to and
progress in the general preschool curriculum for young children
with disabilities (Horn, Lieber, Sandall, Schwartz, & Li, 2002;
McBride & Schwartz, 2003; Sandall et al., 2008). Using a building blocks analogy, Sandall and colleagues characterized these
evidence-based components as a set of stacked building blocks,
with the base being a high-quality early childhood program and
more specialized supports, including curriculum modifications,
embedded learning opportunities ( ELOs), and specialized instruction, nested on top. A modification and extension of this building
blocks model, recently proposed (Horn, Lieber, Palmer, & Butera,
2008) and illustrated in Figure 1, has at its foundation a highquality, universally designed curriculum that supports all childrens
access to and participation in the general curriculum. Childrens
individualized needs for supports are provided through instructional
individualization including curriculum modifications and ELOs.
The decision for when and what form the supports should take
is determined through assessment and by linking desired child
outcomes to curriculum content and the individualized child
supports.
The primary purpose of this article is to provide a closer look at
the individualization process in which we ensure that the individualized learning priorities for each child are appropriately addressed. First, to better understand the foundation on which the

Figure 1. Framework for supporting all childrens access to and

progress in the general curriculum.

individualized supports are built (i.e., the high-quality, universally

designed curriculum), background information on the critical
elements of a high-quality curriculum is presented.

High-Quality, Universally Designed Curriculum

A curriculum can be described as the course of study for
a given group of learners. The curriculum provides a blueprint for
childrens learning that the early education team can follow as it
implements daily learning activities ( National Association for the
Education of Young Children and National Association of Early
Childhood Specialists in State Departments of Education [NAEYC
& NAECS/SDE], 2003). Just as a contractor building a house for
a family follows a blueprint to ensure that it meets expectations for
quality and design priorities, an early educator or SLP follows a
curriculum in order to meet community and family expectations as
well as childrens unique learning needs. The curriculum is more
than a collection of enjoyable activities that occur in the preschool
classroom; the curriculum is a set of plans and activities that lead
to childrens learning (Marsh & Willis, 1995). The curriculum
should serve as a comprehensive guide for instruction and dayto-day interactions with young children (Branscombe, Castle,
Dorsey, Surbeck, & Taylor, 2003; Trister-Dodge & Bickart, 2003;
Wolery & Sainato, 1996). The curriculum is the what of early
education; it is the content that the educators and related services
professionals provide and that the children learn (Nolet & McLaughlin,
2000). It is separate from the strategies or procedures that are used
to teach children the content, although the line between curriculum
and instruction often is difficult to separate in day-to-day practice.
Four key conceptsdevelopmentally appropriate practices ( DAP),
universal design for learning principles, functional outcomes, and
naturalistic instructional approachesheavily influence our beliefs
about the dimensions of high-quality curriculum.
DAP. DAP describes an approach to curriculum and teaching
that recognizes the child as an active participant in the learning
process who constructs meaning and knowledge through interactions with people and materials in the environment (Bredekamp
& Copple, 1997). Decisions about the content of the curriculum
should be based on at least three important kinds of information:
(a) child development and learning; ( b) the strengths, interests, and
needs of each individual child in the group; and (c) the social and
cultural contexts in which children live (Bredekamp & Copple,
1997). The curriculum should include skill development as well
as opportunities for child-initiated interests and activities. Furthermore, from a DAP perspective, the early educator or an SLP should
plan for childrens individual needs and interests by coordinating, orchestrating, and facilitating learning with active participation by the children. For example, the SLP should plan the
childs therapeutic goals, ensuring that the goals (a) align with
what is developmentally appropriate for the child at his or her age,
( b) capitalize on the childs strengths and needs, and (c) are sensitive to the cultural and social backgrounds of the child and his or
her family.
Universal design for learning principles. Traditionally, the
primary method used to address individualization has been through
educators and related services personnel such as SLPs working
together to address an individual childs needs for individualized
modifications (Orkwis, 2003). These efforts are appropriate; however, they are geared toward the individual child and are added after
the fact. Just as after-the-fact architectural accommodations are

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often awkward and expensive, making the curriculum accessible

after the fact can be time consuming, challenging for the team, and
beneficial to only a small number of children at a given time or
within a given activity. A more efficient way to promote access for
all children is to address a range of user abilities and needs within
the general curriculum by incorporating flexible goals, methods,
and materials that accommodate learner differences.
These embedded accommodations, or universal design, for
teaching and learning provide team members with a blueprint
for creating flexible goals, methods, and materials that accommodate learner differences (Center for Applied Special Technology
[CAST], 2006, p. 8). Furthermore, incorporation of universal design for learning within an early childhood curriculum focuses on
creating learning environments and adopting practices that allow for
access and participation by all children, regardless of individual,
cultural, or linguistic differences (Hanna, 2005). A curriculum that
incorporates universal design for learning from the beginning rather
than as an after-the-fact adaptation provides all children with a
variety of formats for responding; using resources and materials;
demonstrating what they know; and expressing their ideas, feelings,
and preferences (National Center on Accessing the General Curriculum, 2003).
There are three components of the educational environment
that should be considered in a universal design for learning: the
physical environment, the socialemotional environment, and the
teaching and learning environment (Conn-Powers, Cross, Traub,
& Hutter-Pishgahi, 2006). A review of the physical environment
guided by the principles of universal design would include addressing such questions as whether space is sufficient and arranged
in such a manner that all children can safely access activities and
materials. This includes the physical structures of the classroom
as well as other areas such as hallways and outdoor spaces, play
equipment and furnishings, storage, and classroom / learning
materials.
The socialemotional environment addresses the important component of membership or belonging. In evaluating the effectiveness of the classroom and classroom activities in addressing this
component, early education professionals must ensure that all
children are included and eliminate any potential actions that might
segregate or stigmatize a child. This has the potential for being a
critically important question for SLPs as they work within classroom
contexts to provide specialized services and supports.
It is through a review of the teaching and learning environment
that the educational team really gets at the heart of whether or not
the curriculum meets the core principles of universal design for
learning. Three key principles of universal design for learning have
been identified and are defined as follows:
& Multiple means of representation ensure that instruction,
expectations, and learning opportunities are provided in
various formats and at different complexity levels, addressing
a range of ability levels and needs.
& Multiple means of engagement ensure that various opportunities are presented for arousing childrens attention, curiosity,
and motivation, addressing a range of interests, preferences,
and personal learning styles. Engagement is maintained by
providing various levels of scaffolding, repetition, and
appropriate challenges to ensure successful learning.
& Multiple means of expression ensure that children have a
variety of formats for responding; demonstrating what they

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know; and expressing ideas, feelings, and preferences

(Blackhurst et al., 1999; CAST, 2006).
Building in these elements of flexibility ensures that children
are not bound by a single way of participating, nor do children
have to wait to fail before supports are provided. Here again,
the role of the SLP is to understand these guiding principles and
work together with the other team members to identify potential
areas of concern or improvements for ensuring that the principles are
in place.
Functional outcomes. Traditionally, most early educators have
promoted the belief that learning outcomes for young children, including children with special needs, should be based on what is
expected of typically developing children (Carta & Kong, 2007). In
this scenario, curriculum content centers on mastery of skills that
follow a developmental sequence (McWilliam, Wolery, & Odom,
2001). A modification of this view, a functional perspective, selects
skills based on their function in allowing the child to participate
more fully in a variety of community settings. In this approach,
curriculum outcomes are adapted based on the childs needs and the
belief that a clear reason for teaching each skill must be identified.
Pretti-Frontczak and Bricker (2004) proposed that when taking a
functional outcomes perspective, all skills targeted for instruction
should be immediately useful; usable across settings, people, and
materials; and part of the childs natural daily environment. Functional outcomes are thus meaningful to the child and promote the
acquisition, generalization, and maintenance of skills (Bricker, PrettiFrontczak, & McComas, 1998; Kashinath, Woods, & Goldstein,
2006). For example, an expressive language goal of vocabulary
development may be defined in functional terms by selecting the
objects/verbs to be taught to a child from within the childs environment, context, and natural routines or within the childs repertoire.
The SLP can play an important role in supporting the educational
team in ensuring that functional outcomes are selected and intervention on these outcomes is conducted within a functional perspective. The SLP brings to the table extensive knowledge in terms
of the developmental sequel of speech, language, and communication and can serve as a translator of the specific learning needs of
a young child such that the intervention can be designed within a
context that demonstrates immediate usefulness.
Naturalistic instructional approaches. As educators and SLPs
have attempted to meet the challenge of achieving meaningful, functional outcomes in learning and development for all children, they
have embraced the use of naturalistic approaches (Lowenthal, 1995:
Noonan & McCormick, 2006). These approaches attempt to integrate the theories of Vygotsky, Piaget, and Dewey while using learning principles espoused by behavior analysts (Bruder, 1997, p. 530).
Similarly, group interventions (also known as group therapies or
group treatments) within the classroom environment have been used
for more than 50 years in speech and language studies (e.g., Backus
& Beasley, 1951; Nemoy & Davis, 1937). Group interventions
ensure a psychosocially enriched environment and improved efficiency for SLPs (Goldberg, 1993). Also known by names such as
incidental teaching, milieu language intervention, and activity-based
instruction, naturalistic language intervention approaches share several characteristics:
& The contexts for instruction are the natural social and
nonsocial learning opportunities and experiences of the child
such that instruction is conducted as situated learning (Dunst,
Hamby, Trivette, Raab, & Bruder, 2000).

SCHOOLS Vol. 40 406415 October 2009

& The content or individualized goals for instruction reflect

the skills needed by the individual child in order to
meet the demands of natural, age-appropriate environments.
The content in turn grows with the child as the number of
environments in which the child participates increases and the
demands for competence in the environments change with
time ( Yoder & Warren, 2001).
& Individual teaching episodes are typically very brief, minimally
intrusive, and distributed or spaced over a period of hours or
days. That is, the instructional episodes appear to the observer
to be similar to naturally occurring events (Wolery, 2001).
& Instructional interactions typically are child initiated or
those that have been initiated by an adult based on the childs
focus of attention and interest and thus take advantage of
the childs motivation in order to evoke a target behavior
(Kaiser, 2000).
& The instructional interaction should reflect a goodness of fit
between the instructional method and the childs response to
intervention. For example, in using instructional prompts, if
the child demonstrates a resistance to physical prompts or
guidance, the adult should use other levels of prompts (e.g.,
verbal guidance; Dunst et al., 2000).
& The instructional interaction uses natural consequences
such as desired materials or events for the childs responses
(Bricker et al., 1998; Camarata, Nelson, & Camarata, 1994).
& The teachers who are implementing the naturalistic
instructional interactions are the adults (e.g., early educators,
parents, siblings, caregivers, paraeducators) who interact with
the child on a regular basis because of their participation in
the childs everyday, natural environments (Kaiser & Hester,
1994).
Naturalistic instructional approaches can be implemented in a
variety of child learning environments and service delivery models,
including home visiting, child care, community preschools, and
public schools, as well across professionals, including teachers,
SLPs, school counselors, and occupational therapists. Furthermore,
naturalistic instructional procedures can be applied to address a
variety of skills and promote development in children across a
variety of developmentally important domains. For example, the
SLP may provide teachers with a list of target concepts or words
from the childs goals and suggest strategies to use these concepts
in naturally occurring communication in the classroom in order to
reinforce and help generalize the concepts.
There is an extensive literature on the use of naturalistic approaches to promote skill acquisition in children with disabilities
(Rule, Losardo, Dinnebeil, Kaiser, & Rowland, 1998; Seifert &
Schwarz, 1991). Probably the earliest use of this approach, called
incidental teaching by Hart and Risley (1968, 1975), was developed
to facilitate childrens language and communication skills. Incidental teaching is characterized by an unstructured activity such
as free play or snack; an initiation or request (verbal or nonverbal)
on the part of the child, which sets the occasion for language
learning; and a response from an attentive adult. Hart and Risley
found that children who participated in teachers incidental interactions generally increased their competence in producing language
targets.
The incidental teaching approach was refined, extended, and
experimentally validated in numerous studies by Warren, Kaiser,

and their colleagues, who developed milieu teaching procedures

(e.g., Warren & Kaiser, 1988). Milieu teaching relies on following
the childs interests and embedding the teaching episode into
ongoing interactions between the teacher or SLP and the child. The
procedure was expanded and is now often referred to as enhanced
milieu teaching, with the addition of environmental arrangement
strategies and the use of components of responsive interaction
strategies or strategies that promote a balanced communication
exchange between the child and the adult in a conversational manner (Kaiser, 2000). Evidence indicates that this approach results in
improvement of childrens use of language during conversations
(Kaiser, 2000; Kaiser, Ostrosky, & Alpert, 1993; McCathren &
Watson, 2001; Warren, Yoder, Gazda, Kim, & Jones, 1993).
In the 1990s, the use of naturalistic strategies was expanded
to address learning in domains other than language development,
including prelinguistic or alternative communication (e.g., Garfinkle
& Schwartz, 2002; McCathren & Watson, 2001; Warren et al.,
1993), cognitive (e.g., Grisham-Brown & Hemmeter, 1998), motor
(e.g., Horn et al., 2002), social (e.g., Brown, McEvoy, & Bishop,
1991; Nordquist, Twardoza, & McEvoy, 1991), and adaptive (e.g.,
Venn et al., 1993). Thus, although initially developed and researched
in the context of language and communication intervention, over
several decades, naturalistic strategies have been shown to be effective
across a range of behaviors and settings. Furthermore, naturalistic
procedures are part of the recommended practices that are promoted
for use in the field of early childhood special education /early intervention by the Division for Early Childhood (DEC; Sandall,
Hemmeter, Smith, & McLean, 2005).

Instructional Individualization
A high-quality, universally designed curriculum incorporating
the four key aspects described in the previous section is essential
for ensuring not only access to, but also meaningful participation
across, daily routines and activities for all young children, particularly those with disabilities or those who are at risk for developing disabilities (DEC, 2007). However, the implementation of a
high-quality, universally designed curriculum does not take away
the need to make modifications to meet the individual needs of
specific children. To support the achievement of priority learning
outcomes for young children with disabilities, the universally designed general curriculum should be viewed as the cornerstone to
which all instruction is anchored or, as noted previously in Figure 1,
the foundational block in building an effective implementation
model ( Horn et al., 2008). How then do we address the next element
or block of the modelinstructional individualization?
An important function of an educational team (including but
not limited to early childhood special educators [ECSEs], SLPs,
and occupational therapists) for children with disabilities should
be to develop goals and objectives that (a) meet the unique needs
of the child, ( b) are meaningful for the child, and (c) are functional
in a variety of contexts (Noonan & McCormick, 1995; NotariSyverson & Schuster, 1995). However, these goals and objectives
must not become the childs curriculum. Developing appropriate
goals and supporting the individual needs of young children with
disabilities requires ECSEs to anchor their child program planning
in the expectation of the general education curriculum. Meeting
the mandate of access to and progress in the general curriculum
requires educators to help the child access the environment and

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participate in the activities (Nolet & McLaughlin, 2000). In addition, all team members must provide opportunities for the child
to learn the important content reflected in the curriculum that is
offered to all children in the early education program through a
variety of individualized supports and modifications. The following
vignette provides examples of the types of individualized instructional supports and curriculum modifications that can be planned
and implemented.
Trent attends a community preschool in which teachers and related
services personnel use a high-quality, universally designed curriculum.
Trent was diagnosed with a medical condition that resulted in general
developmental delay. He receives services from the local schools
IEP team, which includes an SLP who regularly visits the classroom
and works with the teachers and Trents parents to plan curriculum
modifications and individualized instruction. For example, Trent needs
some support to maintain active engagement. So working together,
the team developed a plan to provide for a variety of curriculum
modifications to ensure that Trents individualized needs for supports to
maintain active engagement are addressed. For example, when reading
the story that accompanies each lesson, the teacher makes room for
Trent to sit nearby so that he can see the book and experience fewer
distractions (i.e., provision of invisible support). This allows him to
access information along with the other children. Additionally, Trents
parents have a copy of the books that are used in the curriculum, and they
work ahead of the teachers to introduce Trent to the material so that he
will be able to benefit even more when the teacher introduces the books
in the classroom. Repeated exposures to a book is an example of a
curriculum modification in which the task was simplified (i.e., simplify
activity), thus allowing Trent to be actively engaged and responsive to the
discussion and content. The SLP suggested that Trents teacher also
encourage Trent to look at the book and talk with her about it during
center time, providing Trent with the curriculum modification of adult
support so that he can fully understand the content. In addition, the
teacher uses this time as well as other targeted opportunities during the
day to provide Trent with individualized instruction or ELOs to address
his individual learning priority of increasing expressive language
vocabulary and maintaining attentional focus. The SLP develops a
list of potential opportunities in the natural environment for Trent to
expressively use vocabulary from the books and models these for the
classroom staff when she is in the setting. Furthermore, the SLP embeds
work on Trents learning priorities into her individual interactions and
small-group session with Trent. (Lieber, Horn, Palmer, & Fleming,
2008)

To facilitate the process of describing the instructional

individualization block (illustrated in the vignette above) of
the implementation model presented in Figure 1, the block has
been grouped into two sets of strategies (i.e., curriculum modifications and ELOs) and is described in detail in the following
sections.

Curriculum modifications. A curriculum modification is a

change in a classroom activity or material that allows a child to
participate (Sandall et al., 2008). Note that while in early childhood,
the distinction is not as clear, services for school-age children make
a distinction between the terms accommodation and modification.
Whereas accommodation is an alteration of an environment, curriculum format, or equipment that allows a child with a disability
to gain access to content, modification is a change in the curriculum
itself, leading to individualization of the curriculum in order to
increase the childs participation and effective inclusion in the
classroom (Nolet & McLaughlin, 2000). Increased participation
creates more opportunities for the child to learn. A curriculum
modification strategy should be used when the child is interested
in the ongoing activity but is not able to fully participate or may
not stay with the activity long enough. The key is to help the child
participate. Researchers from the Early Childhood Research Institute on Inclusion identified and described eight types of modifications and adaptations to support a childs inclusion in the classroom:
environmental support, material adaptations, special equipment,
use of childrens preferences, simplification of the activity, adult
support, peer support, and invisible support (Horn, Lieber, Sandall,
Schwartz, & Wolery, 2002; Lieber, Schwartz, Sandall, Horn, &
Wolery, 1999; Sandall et al., 2008). Table 1 provides a brief description of each category.
Three of the modification strategies address changing or adding
materials or events within the classroom (i.e., those things that
are external to the child). Environmental support refers to altering
the physical, social, and temporal environment to promote the
childs participation, engagement, and learning. For example, the
teacher of Isaiah, a 4-year-old child with significant physical limitations, changed the layout of the various areas of the classroom
slightly in order to enable Isaiahs wheelchair to be moved easily
from one area of the classroom to another even when one of his
peers with less experience and skill was driving. Material adaptations occur when teachers modify materials so that the child
can participate as independently as possible. Examples of material
adaptations for Isaiah might include stabilizing materials such as
taping the paper for painting to the table, using Velcro straps to hold
the paintbrush in Isaiahs hand to compensate for his weak grasp,
using nonskid backing under the paint cup, and using contact paper
as backing for collages because gluing is too difficult for him.
Special equipment is another modification that might be used to
support Isaiah. Special equipment includes homemade as well as
commercially available therapeutic equipment. For example, Isaiah

Table 1. Curriculum modification categories and definitions.

Category
Environmental support
Material adaptations
Special equipment
Use of childrens preferences
Simplification of the activity
Adult support
Peer support
Invisible support

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Refers to adults altering the physical, social, and temporal environment in order to promote the childs
participation, engagement, and learning.
Occur when teachers modify materials so that the child can participate as independently as possible.
Includes homemade as well as commercially available therapeutic equipment.
Refers to adults identifying child preferences and integrating them into the activity to make it more motivating.
Refers to adults breaking a complicated activity into smaller parts or changing or reducing the steps involved.
Occurs when adults model an appropriate behavior, join the child in play, praise the child, and /or provide encouragement.
Refers to adults providing peers with support and training so that they can help children with severe disabilities
reach their learning objectives.
Occurs when adults rearrange aspects of naturally occurring activities to support the childs success in participating.

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has a special switch positioned on the tray of his adapted wheelchair

at all times that he can press to call for assistance. Similarly,
Isaiahs portable 4-symbol speech output device allows him to be
an active participant in the classroom.
Two of the modification strategies focus on matching activities
with the childs abilities and preferences: use of childrens preferences and simplification of the activity. If the child is not taking
advantage of the available opportunities, the adults can identify the
childs preferences and integrate them into the activity to make it
more motivating. For a child with Isaiahs physical and movement
challenges, a physical therapist might indicate a need for Isaiah
to actively participate in moving his limbs, particularly his legs. To
address this need, Isaiahs early education team, seeing that Isaiah
really loves to participate in the finger play activities of opening
group time, could add some songs that require peddling and stepping movements of the childrens legs and praise Isaiah for his efforts at moving his legs like his friends. The SLP could then add
phrases for Isaiahs favorite activity on his speech output device. Simplifying a complicated activity by breaking it into smaller parts or
changing or reducing the steps involved is the second strategy in this
group. Returning to Isaiah for an example, when completing puzzles with the other children, Isaiah could be provided with a puzzle
in which only two and later three pieces are out of place. Isaiah could
then use a sliding movement to slide the pieces into their correct slots.
The final set of modification strategies focuses on providing
adult, peer, or invisible support to the child. In adult support, an
adult may model an appropriate behavior, join the child in play,
praise the child, and /or provide encouragement to the child. For a
child like Isaiah, the following scenario might occur.
With paintbrush in hand and everything set up to paint, Isaiah is
watching the other children as they paint. The adult joins in, commenting
to Isaiah that she, too, really enjoys seeing what the other children
are painting. She then turns to Isaiah and says, Lets see what you
can paint. She then assists Isaiah in getting paint on his brush and
praises Isaiahs brush strokes on the paper, noting that he has the same
color as another child.

Peers also can help children with disabilities reach learning objectives. For example, Isaiahs peers could provide him with the
picture choices of the next center he would like to participate in and
then drive his chair to the area once he has indicated his choice.
Finally, invisible supports occur when adults rearrange aspects of
naturally occurring activities to support the childs success in participating. For example, if Isaiahs classmates were making a card with
a heart shape created by red paint fingerprints of each child as a
farewell gift to a volunteer, the adults could make sure that Isaiah
was first in line for placing his fingerprint because his accuracy of
hitting a target is limited and thus he would not be in danger of
placing his fingerprint on top of another childs.
ELOs. Used well, curriculum modifications like those described
above can certainly help support childrens active participation in
the activities and curriculum content of the early learning environment. However, curriculum modifications may not be sufficient
to ensure that the child has learning opportunities to meet the goals
and outcomes stated on his or her IEP or individualized family
service plan ( IFSP). In order to ensure that the child with disabilities
has learning opportunities to meet his or her individually defined
needs, an instructional modification might include providing opportunities for planned, brief instructional episodes across curriculum
activities to provide direct instruction for childrens individualized
learning needs and outcomes (Horn et al., 2002). Drawing from

the rich history of research in naturalistic language intervention

procedures noted earlier (i.e., Hart & Risely, 1975), early education
professionals have recommended embedding intervention across
multiple domains of learning into existing curriculum activities and
home routines (Bricker & Cripe, 1992; Davis, Kilgo, & GamelMcCormick, 1998; Horn et al., 2002; Noonan & McCormick, 2006;
Wolery & Wilburs, 1994). Furthermore, DECs recommended practices (Sandall et al., 2005) endorse embedded instruction as an
evidence-based practice and state that specialized procedures
(e.g., naturalistic instructional strategies and prompt/prompt fading
strategies) are embedded and distributed within and across activities (Sandall et al., 2005, p. 91).
Embedding is a procedure in which children are given opportunities to practice goals and objectives that are included within
an activity or event in a manner that expands, modifies, or adapts
the activity/event while remaining meaningful and interesting to
children (Bricker et al., 1998, p. 13). These teaching episodes have
sometimes been referred to as ELOs (Horn et al., 2002). ELOs
are based on the premise that in order for many children to achieve
their learning objectives, providing access to the general early childhood curriculum is insufficient. In order for children with disabilities to learn new or more complex skills within the context of
the general curriculum and early learning and care environments,
the early education team needs to provide instruction through
modeling, verbal prompting, and physical guidance. Members of
the early education team, including the SLP, should identify the
opportunities that are most salient to individualized learning objectives and embed short, systematic instructional interactions that
support childrens achievement of goals within existing routines
and activities. For example, rather than the SLP setting up special
sessions to have Isaiah (the child with multiple disabilities noted
earlier) learn to indicate choice with an eye gaze, the SLP could
go to the classroom during center time, join Isaiah in his group, and
embed the use of choice into the ongoing activity. The SLP could
also work together with the classroom staff to identify and plan
for additional practice opportunities for Isaiah throughout the
school day. For example, the SLP could set it up so that Isaiah must
choose between two peers photographs to indicate by whom he
wants to sit during the opening circle, or between a drawing of a cup
or spoon to indicate whether he is ready for a drink or bite of food
during his snack, or between two symbols for center options to
indicate to which center he would like to move next, and so on.
Thus, the SLPs role in supporting the achievement of a childs
individual learning outcomes is as a guide in identifying outcomes
and opportunities within the natural curriculum of the group and
home setting and modeling the intervention techniques to facilitate
the childs progress toward achieving the outcome.
With ELOs, the activities and routines become the structure
for supporting childrens learning. Many of the activities are child
initiated, so they presumably are motivating (Bricker & Cripe,
1992). By embedding effective instruction into fun and motivating
activities, learning often occurs more quickly (Losardo & Bricker,
1994). More importantly, because the children have learned the
skill in a more natural setting, they are more likely to be able to use
the skill when they need it to obtain an item or participate in an
activity. Teachable moments are recognized, created, and used to
enhance a childs developmental progress. As with all good instruction, progress toward achieving learning objectives is monitored. Instructional decisions such as progressing to more complex
or next level skills or changing the instructional procedures are

Horn & Banerjee: Embedded Learning Opportunities

411

made through careful analysis of data collected. The focus is on

access to and participation in fun, enjoyable, and interesting
activities for young children while making learning progress.
A systematic review of the empirical literature related to ELOs or
embedded instruction was completed as a part of the DEC recommended practices project (Sandall et al., 2005). The systematic review showed that ELO practices have substantial empirical support
(e.g., Ducharme, Lucas, & Pontes, 1994; Hundert & Houghton,
1992; Hutzler, Chacham, Bergman, & Szeinberg, 1998; Kim &
Lombardino, 1991; Losardo & Bricker, 1994; OConnor, NotariSyverson & Vadasy, 1996; Pratt, Heintzelman, & Deming, 1993;
Pretti-Frontczak & Bricker, 2001; Sewell, Collins, Hemmeter, &
Schuster, 1998). These practices have been shown to be effective
for teaching young children a variety of functional and developmentally appropriate skills, including language, early literacy, and
social skills (Daugherty, Grisham-Brown, & Hemmeter, 2001; Filla,
Wolery, & Anthony, 1999; Fox & Hanline, 1993; Grisham-Brown,
Shuster, Hemmeter, & Collins, 2000; Horn, Lieber, Sandall, Schwartz,
& Li, 2002; Kohler, Anthony, Steighner, & Hoyson, 1998; Kohler,
Strain, Hoyson, Jamieson, 1997; Malmskog & McDonnell, 1999;
Schwartz, Carta, & Grant, 1996; Sewell et al., 1998; Venn et al., 1993).
Furthermore, an ELO approach has been shown to enhance generalization of learned skills (Fox & Hanline, 1993; Losardo & Bricker,
1994; Wolery, Anthony, Caldwell, Snyder, & Morgante, 2002).
In addition to evidence of their effectiveness with children,
ELOs have been rated favorably by members of the early childhood
team, including educators and related services personnel (Horn
et al., 2002; Sandall, Schwartz, & LaCroix, 2004). As part of the
field validation of DECs recommended practices, when respondents were asked to indicate whether they thought embedded learning strategies should be a recommended practice, 88% either
agreed (30%) or strongly agreed (58%) (Smith, McLean, & Sandall,
2005). However, studies have also demonstrated that embedded
learning strategies frequently are not used with high levels of fidelity (Filla et al., 1999; Horn et al., 2002; McBride & Schwartz, 2003;
Pretti-Frontczak & Bricker, 2001; Schuster, Hemmeter, & Ault,
2001; Smith, Warren, Yoder, & Feurer, 2004).
Thus, to reiterate, ELOs have an empirical research base and
wide theoretical and practical support in early intervention/early
childhood special education. However, the lack of clear evidence
for the widespread use of ELOs certainly points to a need for further
study. In addition, we would argue that embedded learning strategies have the strongest likelihood of being a useful and effective
instructional tool if they are viewed as part of a continuum of instructional practices designed to support active participation and
meaningful learning by young children with a disability within the
natural everyday environment and general curriculum. That is, as
an instructional strategy, ELOs should be reserved to address the
instructional and learning needs of a child when a high-quality
curriculum and curriculum modification are not sufficient. Said
another way, the role of the ELO in a multitiered level of support
is to provide for direct instructional opportunities directed toward
the childs individual, unique learning priorities, which may not
be addressed, or with enough intensity, to allow the child to achieve
the desired learning outcome.

Issues in Implementation
In a multitiered system of support like the one presented in
Figure 1, each component/lock fulfills an important role. The

412

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HEARING SERVICES

IN

curriculum promotes high expectations for all childrens growth,

learning, and development. Instructional individualization through
curriculum modifications provides for a first level of accommodations for differences in learning style, strengths, and needs noted
through initial assessment and through ongoing documentation
of the childs responses to the curriculum and learning activities.
ELOs as the highest level or most intensive support allow for maximized individualization but still within the context of a common,
inclusive environment. Although the components of a multitiered
model make logical sense, have relatively solid empirical support,
and are solidly embedded in recommended practices, significant
challenges toward full realization of positive outcomes for children still remain. Three obvious challenges relate to understanding
and validating the multiple tiers as a package, implementing a
collaborative teams approach to service delivery, and addressing the
issue of high implementation fidelity.
Extensive literature in early intervention promotes collaborative teaming between educators ( both general and special), SLPs,
other related services professionals, and families (e.g., Briggs,
1991; Hanline, Nunes, & Worthy, 2007; Hundert & Hopkins, 1992;
Hunt, Soto, Maier, Liboiron, & Bae, 2004; Law et al., 2002; Pea
& Quinn, 2003). Although a collaborative team approach is critical to support positive child outcomes in an inclusive classroom
(Guralnick, 2001; Kaczmarek, Pennington, & Goldstein, 2000;
Lieber et al., 1997; Odom, 2002), challenges to implementing
effective collaboration exist. These challenges include conflicting
goals among team members, lack of communication between team
members, and the reality that families and school personnel
interact with related service personnel as experts rather than as
peers (Hunt et al., 2004, p. 124). Further, too often intervention
by the related services professionals takes place outside of classrooms and may be unrelated to the classroom goals. To the heart
of this issue are two factorslack of adequate resources and lack
of adequate preservice trainingthat serve as barriers to the establishment of collaborative environments (Crowe, Leiting, & Ogden,
1994). Providing time and space for regular meetings between
professionals is crucial. Further, it is imperative for our training
institutions to train our professionals to instill the practice of mutual
goals, shared responsibilities and accountability, and parity among
professionals.
Probably nothing affects the quality of the intervention that
young children with a disability receive more directly than the
knowledge and skills of the adults who work and play with them
(Cost, Quality, & Child Outcomes Study Team, 1995). As our
evidence base for strategies and practices continues to expand,
one of our most significant challenges continues to be the high
fidelity of implementation of these practices on a frequent and
regular basis in the everyday, real world for young children (Carta
& Kong, 2007). The young child with disabilities may receive his or
her teaching and learning opportunities in a variety of places and
at the hands of a variety of different adults with a range of (and
oftentimes limited) background knowledge, skills, and formal
training. Promoting frequent and high-fidelity implementation of
evidence-based practices in this context requires that we rethink
the research-to-practice translation process. There is a growing
recognition that in order to close the research-to-practice gap, new
and creative approaches to dissemination and professional development are needed (Greenwood & Abbott, 2001; Greenwood &
Maheady, 2001). We need to provide clearer identification and
articulation of our evidence-based practices, as well as professional

SCHOOLS Vol. 40 406415 October 2009

development and technical assistance in the use and implementation

of the practices. Our focus must be on ways to ensure frequent
and high-fidelity implementation of a coordinated set of effective
practices, such as those offered through various multitiered or multilevel models of support, that result in positive outcomes for the
young child with disabilities.

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toddlers with developmental delays varied by maternal characteristics.
Journal of Speech, Language, and Hearing Research, 44(1), 224237.

Received March 1, 2008

Revision received July 8, 2008
Accepted October 23, 2008
DOI: 10.1044/0161-1461(2009/08-0026)
Contact author: Eva Horn, University of Kansas, 1122 West Campus
Drive, Lawrence, KS 66045. E-mail: evahorn@KU.edu.

Simmons, D. C., Kuykendall, K., King, K., Cornachione, C., &

Kameenui, E. J. (2000). Implementation of a schoolwide reading improvement model: No one ever told us it would be this hard! Learning
Disabilities Research & Practice, 15(2), 92100.

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