This paper examines the concept of secondary conditions and its application in studies of childhood disability focusing on children with spina bifida as a representative group. The "International Classification of Functioning, Disability and Health" (World Health Organization, Geneva, 2001) provides a classification of body function/structure, activities, participation and the environment to document dimensions of human functioning in context. The ICF is of value in the study of secondary conditions in two ways: as a conceptual framework for defining impairments, activity limitations and participation restrictions, and the mediating role of the environment in their expression; and as a taxonomy for coding these dimensions of disability. The ICF can yield a profile of a child's difficulties, and documentation of environmental barriers experienced by that child. Research studies with children and adolescents with spina bifida reveal that physical and mental impairments and limitations in performing activities and participating in communal life are experienced as secondary conditions. The significance of secondary conditions is that they are preventable. Identifying the mechanisms associated with their manifestation is thus an important priority for the development of effective prevention programs.

The provision of Individualized services to families with young handicapped children has been hampered by the lack of a practical model. This article describes a functional model for assessing family needs, specifying family goals, implementing family services, and evaluating effectiveness. The model draws on the "goodness-of-fit" concept to individualize family services in order to optimize the "fit" between family, child, and services provided. 0 The importance of family involvement is a recognized principle in early intervention. Even though a recent meta-analysis of research suggests that empirical data to sup-

Multivariate analysis revealed that school life in elementary, middle and high school could be defined by six distinct factors describing individual and group roles. Structural equation modelling yielded a second order latent variable that captured the complex and multi-dimensional aspect of participation, accounting for availability, eligibility, student characteristics/status, and student choice within a larger framework of participation.

This article summarizes the status of, and recommendations for, preparation programs for early intervention personnel across eight disciplines. Surveys were conducted to determine the extent to which entry-level students in each discipline receive academic preparation and clinical experiences to provide services to infants and toddlers with disabilities and their families. Although considerable variability was found across disciplines, the average student receives little specialized information—practical knowledge—relative either to the infancy period or to working with families. Alternative strategies for improving infant personnel preparation are discussed and policy implications of each are addressed.

The rapid increase in services for infants with handicaps and their famiies has heightened the need for qualified special education professionals. This article reports the results of a telephone survey to a random sample of preservice training programs, a mail survey sent to programs with an infancy or early childhood focus, and a working conference with leaders in infant personnel preparation. The purpose of those activities was to determine the current status of preparing special educators to work with infants and toddlers with handicaps, as well as with their families, and to identify current needs for training materials and curricula associated with that effort. Results indicated that typical students receive very little content related to infants or families in either undergraduate or graduate special education. Substantially more coverage was found in programs specializing in infancy or early childhood; furthermore, programs with an infancy focus (0-3 years) had more infancy coverage than did programs with a broader early childhood focus (0-5 years). No differences between early childhood and infancy programs were found in family assessment and intervention. The small number of graduates found in specialized programs, however, is not likely to meet the need for qualified professionals. Implications of the findings for training and materials development are discussed.Within the field of early childhood special education, a distinction often is drawn between the infancy and preschool periods.Public Law 99-457 has reinforced this distinction by allowing lead agencies other than education to provide infant services, creating separate eligibility criteria and funding formulas, and establishing different guidelines for program planning and service provision, with a particular emphasis on family-based services during infancy. These differences are reflected in practice, with infant programs more likely to be home-or hospital-based and family-focused, with services offered by multiple agencies and professionals. Preschool programs, on the other hand, are more often center-or schoolbased, with services primarily provided by early childhood special educators.The implications of this differentiation for personnel preparation have not gone unnoticed. Severe shortages of personnel with ex-