People and Community Research

Preschoolers with special needs benefit from evidenced-based practices

University of Miami graduate student Elena Fernández spent the summer completing a fellowship in Baltimore, where she assessed the performance of special needs children whose ages ranged from infancy to 5 years old.
Elena Fernandez

Graduate student Elena Fernández conducted a fellowship this summer at the Kennedy Krieger Institute in Baltimore, Maryland.


Academic research on children with special needs is often overlooked.

That is why the work accomplished by University of Miami Ph.D. student Elena Fernández is significant. She was one of 24 recipients of the James A. Ferguson RISE Fellowship, part of the Center for Diversity in Public Health Leadership Training at the Kennedy Krieger Institute. 

The Kennedy Krieger Institute, based in Baltimore, Maryland, is a world premier institution dedicated to improving the lives of children, youth, and adults with, and those at risk for, disorders of the developing nervous system—through innovative, equity-based, and culturally relevant clinical care, research, education, community partnership, advocacy, and training.

Fernández’s work focused on studying how evidenced-based practices in early childhood centers could enhance and improve the outcomes of special needs children.

“As a Baltimore native, I have always admired the work done by Kennedy Krieger Institute,” said Fernández. “So, I was very excited to work with the best in the field.”

Laura Kohn-Wood, dean of the School of Education and Human Development, said Fernández’s fellowship “reflects the outstanding doctoral training in the School of Education and Human Development’s Department of Teaching and Learning, as well as her focused intellect.”

“We are proud of her accomplishments thus far and look forward to hearing about her undoubtedly future formidable impact on the field,” Kohn-Wood added. 

Over a nine-week period this summer, Fernández carried out research and on-site observation in the centers that provided care to 136 children, most of them ages birth to 5 years old.

One center catered to children with autism, another one served children and families that faced housing insecurities, and the third cared for children with medical needs with a full-time nursing staff available to address those needs.

She found that 77 percent of the population of these centers were non-Hispanic Black people, 12 percent were white, 4 percent Hispanic, 3 percent multiracial, and 2 percent Asian. Seventy-seven percent of the children and their families qualified for government assistance of some kind, including Medicaid.  

In her research, Fernández also discovered that there was a gap in the studies of these children. Most of the literature on children with special needs tends to focus on children in grades K-12, despite the evidence of effectiveness of early childhood services, she noted.   

“The need for evidence-based practices and assessment tools that are sensitive enough to be used with children with special health care needs became more apparent this summer,” she said. There needs to be more nuanced research on the academic and developmental progression of children with special needs, she pointed out.   

Fernández also detected that those centers that used evidenced-based practices—ways to teach that have been proven through research to have efficacy—were the most successful in improving the performances of their students.

These practices included:

  • Exposing the students to team projects that encouraged working with others.
  • Creating responsive classroom environments where the teachers followed the child’s lead in conversations and continued to build on the comments the child made.
  • Integrating the needs and goals of the family in the work with the children.
  • Providing participation in inclusive preschool playgroups so that children with developmental disabilities or delays are included in playtime with typically developing children.

“Evidenced-based practices matter because the majority of children who participated in these programs were actually able to transition out of special education and into regular education classes once they entered kindergarten,” Fernández said.

Jacqueline Stone, chief clinical officer at the Kennedy Krieger Institute, was one of Fernández’s mentors. She said that the institute is preparing to launch a strategic plan with a “core component that includes early childhood development and education,” so Fernández’s work could not have been timelier.

“Elena assisted in connecting our early childhood education programs by identifying evidenced-based shared approaches utilized by each in educating children with special health care needs and presenting aggregate data allowing us to view whom we serve,” Stone said. “By preparing children early in their development, we know this will influence outcomes even at the preschool age.” 

Fernández said that she hopes to continue her work on early childhood education with children who have had drug exposure during pregnancy. Her goal is to open an early intervention center for these children.