1.1 Concept, Significance, Rationale, Scope, Advantages of Early Intervention
An intervention is a deliberate process by which change is introduced into peoples' thoughts, feelings and behaviors.
Purpose of Intervention
• Identifying curriculum & Instructional practices.
• Developing new, or modifying existing preschool curricula
• appropriate teacher professional development.
• Establishing the efficacy of existing preschool curricula
• Developing and validating early assessment tools
“The Program for Infants and Toddlers with Disabilities is
a federal grant program that assists states in operating a comprehensive
statewide program of early intervention services for infants and
toddlers with disabilities, age’s birth through age 2 years, and their
families”. Part C of IDEA, Dec 9, 2015
It is also commonly reported as being the provision of support (and resources) to families of infants and young children from members of informal and formal social support networks that impact both directly and indirectly on parent, family and child functioning (Dunst, Trivette and Jodry, 1997).
Early intervention for children who have developmental problems is the “systematic and planned effort to promote development through a series of manipulations of environmental or experiential factors initiated during the first five years of life” (Guralnick and Bennet, 1987, p. 19).
Early intervention is a system of services that helps babies and toddlers with developmental delays or disabilities. Early intervention focuses on helping eligible babies and toddlers learn the basic and brand-new skills that typically develop during the first three years of life, such as:
The introduction of planned program deliberately timed and arranged in-order to alter the anticipated or projected course of development.
Preventive – Primary, Secondary
Curative – Treatment, Surgery
Remedial – Aids & Appliances
Early intervention is an early stimulation and enrichment programme for infants and young children with varying types and degrees of disability.
It is primarily used for children with developmental disabilities offering services which will enhance the development of young children. In developing countries, where health services are lacking in urban slums and deprived rural populations and where poverty is widespread, such early intervention services form the basis of ensuring proper care and management of at-risk infants.
Early intervention applies to children of school age or younger who are discovered to have or be at risk of developing a handicapping condition or other special need that may affect their development.
Early intervention means finding the specific ways to help a child become as functional as possible.
Early intervention can sometimes help a child catch up to peers There are three primary reasons for intervening early with an exceptional child:
1. to enhance the child's development,
2. to provide support and assistance to the family, and
3. to maximize the child's and family's benefit to society.
Effectiveness of Early Intervention
Ø needing fewer special education and other facilitative services later in life;
Ø being retained in grade less often; and
Ø in some cases being indistinguishable from non handicapped classmates years after intervention.
Focus of Early Intervention
• Prevention of disability or delay
• Promotion of positive assets of a developmentally delayed child
• Enhance the capacity of the family to meet the special needs of their infants and toddlers
1.2 Types of Early Intervention
If an infant or toddler has a disability or a developmental delay in one or more of these developmental areas, that child will likely be eligible for early intervention services.
Those services will be tailored to meet the child’s
individual needs and may include:
Services may also be provided to address the needs and priorities of the child’s family. Family-directed services are meant to help family members understand the special needs of their child and how to enhance his or her development
1. Assistive technology
Assistive technology (AT) for infants and toddlers is defined as any item that helps increase the independence and functioning of a child. AT can help with positioning and mobility, communication, play and interaction, learning, and self help. It includes a wide range of items from simple adaptations such as utensils with built-up handles to more sophisticated devices such as wheelchairs, standers, communication devices, and many more. AT with young children can contribute to improving self esteem, reducing child and adult frustration, and enabling independence and participation in daily life. In addition, AT can change the expectations of others for a child’s abilities, and enable active rather than passive play, which is crucial to child development.
2. Audiology or hearing services
The Individuals with Disabilities Education Act (IDEA) ensures that children who have hearing loss receive free, appropriate early intervention programs from birth to age 3 and throughout the school years (ages 3 to 21). Early intervention services for infants and toddlers are family-centered and are designed to:
3. Speech and language services
Speech and Language Therapy Speech and language therapy is also referred to as speech language pathology (SLP), which helps promote receptive and expressive communication and the oral motor skills to speak and swallow. Speech therapy may include using speech, pictures, gestures, and electronic devises.Speech therapy is especially beneficial when kids begin early in life. In one study, 70 percent of preschool kids with language issues who went through speech therapy showed improvement in language skills.SLPs figure out what kind of language problem a student has. They determine what’s causing it and decide on the best treatment. SLPs may help kids build skills by working with them one-on-one, in small groups, or in the classroom.
SLPs can help with:
4.Counseling and training for a family
The Center for Counseling and Training’s trained and caring therapeutic staff helps strengthen families by specializing in helping children, youth and their parents overcome the negative effects of traumatic events such as sexual or physical abuse, loss of a loved one, domestic, school, community violence or other traumatic events. We realize that strong healthy families are the building blocks of a violence-free community. The TCCT has experience working with a variety of therapeutic approaches in which a family is treated as a whole. During the family therapy sessions the members of a family participate with the aim of improving communication between them and the ways in which they relate to each other.
5. Medical services
The role of the Medical services in the coordination of care for children with special health needs and their families is critical for all medical and non-medical service providers who work with the child and family. A Medical services is not a building, but rather a team approach to providing comprehensive primary health care services in a high-quality and cost-effective manner. In Medical services the child or youth, his or her family, primary care physician, and other health professionals develop a trusting partnership based on mutual responsibility and respect for each other’s expertise. Together, families, health care professionals and community service providers identify and access all medical services needed to help the child and family. Infants and young children with special health care needs often receive a variety of medical services which may include: primary health care, specialty medical care, and early intervention services from several allied health or medical providers.
6. Nursing services
Nursing is frequently questioned as to its unique contribution. The holistic health perspective of nursing, which integrates all aspects of the health and well-being of individuals and families, can provide especially valuable insight to the assessment, planning, and service delivery processes. Nurses need to not only participate in the planning process during the interdisciplinary planning meetings, but also to contribute their own assessment and recommendations from a nursing perspective.
7. Nutrition services
Nutrition services are an integral part of the interdisciplinary early intervention team for infants and young children with special health care needs. Provision of nutrition therapy for children is a necessity to ensure that they grow and develop to the best of their ability. Early Intervention Nutrition Services for children can provide the proper guidance to address your child development concerns. Good nutrition is particularly important in the first three years of life, requiring essential nutrient and calorie intake for mind and body development. A child with developmental delays often has a number of contributing factors that challenge their ability to eat.
8. Occupational therapy
Occupational Therapy assists people to participate in their occupations, their activities of everyday life. Occupational Therapy aims to promote independence, health and well-being through meaningful activity. OTs working in early childhood settings makes use of a holistic assessment process that considers the child, family, and other caregivers, the activities and routines that comprise the child’s day, and the environments in which the child and family participate. Goals are then established based on family priorities, child strengths and needs, and assessment results. The OT designs individualized intervention plans that incorporate relevant research evidence, the therapist’s clinical reasoning, understanding of the child and family situation, and input from the child’s parents, teachers, and other professionals. Core philosophies regarding family-centered care, evidence-based practice, theory-based practice, and the importance of occupation and social participation for health and quality of life, all form the foundation for the work of OT in early childhood/early intervention.
9. Physical therapy
Physical therapy is one of the early intervention services under Part C of IDEA. Physical therapy may be the only early intervention service a child needs, or it may be part of a coordinated, multidisciplinary program. Physical therapy is provided as part of the child’s Individualized Family Service Plan (IFSP) through a family-centered care philosophy. Physical therapy can support families in promoting their children’s development, learning, and participation in family and community life. Physical therapists use their knowledge and skills specifically related to motor and self-care function, assistive technology, and medical/ health care science to provide a unique contribution to the IFSP team. Physical therapists provide service by collaborating with the team, exchanging information with the family, and integrating interventions into everyday routines, activities, and locations.
10. Psychological services
Administering and interpreting psychological tests and information about a child’s behavior and child and family conditions related to learning, mental health and development as well as planning services including counseling, consultation, parent training, and education programs. A clinical decision by the psychologist is required on the priority status of each individual referral. The psychologist has responsibility to decide the most effective use of psychology resources and time. Prioritization criteria usually include issues relating to the complexity of presenting referral and family coping. The role of the psychologist is best understood by examining the various phases of service provision: assessment; intervention, and transition into school-aged services.
1.3 Intervention Techniques
An intervention is a deliberate process by which change is introduced into peoples' thoughts, feelings and behaviors.
Intervention helps a Child
Ø Physical development
Ø Language and speech development
Ø Social and emotional development
Ø Adaptive development Cognitive development
Intervention practices should be a collaborative effort that
· focuses on the child‘s needs while capitalizing on the child‘s existing strengths
· is explicit, systematic, and comprehensive
· links intervention activities to family activities
· integrates intervention with the preschool curriculum and makes curricular adaptations as necessary and
· results in functional and meaningful progress that can be sustained over time and across settings.
Swanson (1999) found two major intervention practices that produced large outcomes. One is direct instruction. The other is learning strategy instruction.
And using a sequential, simultaneous structured multi-sensory approach.
Teachers who were applying those kinds of intervention:
a. broke learning into small steps;
b. administered probes;
c. supplied regular quality feedback;
d. used diagrams, graphics and pictures to augment what they were saying in words;
e. provided ample independent, well-designed, intensive practice;
f. modeled instructional practices that they wanted students to follow;
g. provided prompts of strategies to use; and
h. Engaged students in 2process type questions like ―How is that strategy working? Where else might you apply it?
1.4 Record Maintenance and Documentation
‘Record maintenance simply means systematically documenting and storing information collected from various sources using appropriate procedures for a predetermined purpose’.
The first and foremost task a professional carries out when a client approaches him is to register the person – collecting information such as name, address, purpose of visit and so on. This is the beginning of recording. As you know, this will be followed by a number of assessments based on the needs each of which, is recorded suitably by the respective professionals. When the multi/inter disciplinary team meets, these records serve as a source of information for decision making.
The decisions are again recorded so that the document is available during follow up visits of the client and therefore, continuity can be maintained.
Even if the professionals have changed between visits, the records help the new professionals to follow up without difficulty.
The client and family have a base in the records using which they can discuss for further plans for their child.
If the family shifts to another city or changes the service organization for their child, the written comprehensive report provided by the attending professional will help the new agency understand the case and continue with the training.
If there is any deviation in the implementation from the documented plan of action, the discrepancy can be noted immediately for further programme.
Above all, the documents serve as a link between professionals, among themselves as well as with families. With the legal provisions in order, documents and records are likely to serve as the base for resolving issues related to disability rehabilitation.
Now let us look at the specific special educational records and their purposes.
After the team assessment and diagnosis of mental retardation is carried out, the child is referred to a special school or special educational services in non-school setting such as home based or center based training.
Whatever is the setting, records are maintained. Such records are of two types.
2. Educational/Technical records
The administrative records include demographic data, that is, the basic information regarding the child such as name, address, parental occupation, income, family background information, past records of schooling history if any and so on. This may be called registration.
After official formalities, when the child is admitted to the school or the educational programme, there will be a separate entry called `admission entry’ in another register. This is because all the `registered cases’ are not necessarily admitted. Based on the rules and regulations of the organization, the number admitted will be restricted. Other considerations will include age, sex, severity level, SES, availability of seats in a given group and so on.
Now we have two registers – one for registration and one for admission.
The third important administrative record will be for fee collection where entries of various fees, concessions, etc. will be documented.
Other administrative records relevant to the child includes undertaking by the parent on their acceptance/non-acceptance for immediate medical help by the school in case of illness/accident in school, parent’s consent/refusal for including the child in video/photography for publicity purposes and so on. The parent has a right to accept/refuse both of the above mentioned instances which should be honoured. It is always better to get these in writing as it is safe for the organization, in case of legal problems.
Let us now focus on educational or training records, which are essential for monitoring progress. These records include assessment report, attendance register, periodic evaluation procedures and scoring, the individualized educational programmes (IEPs), the record of interaction with parents, task analysis recording, classroom time-tables and the child’s progress report.
A good teacher maintains all of these records, as they help in monitoring progress and analyzing error if any for correction. Let us see how.
1.5 Implication of Early Intervention for pre-school Inclusion
Early intervention and education for children with disabilities can have a positive impact on a child\’s cognitive and social development. Inclusion for early childhood programs supports the right of all children, regardless of abilities, to participate actively in natural settings within their communities. Natural settings include, but are not limited to: home, preschool, nursery school, Head Start program, kindergarten, neighborhood/community, school classroom, child care center, place of worship, recreational space, and other settings that young children and families enjoy.
The young child’s active participation should be guided by developmentally and individually appropriate curriculum. Access to and participation in age appropriate general curriculum becomes central to the identification and provision of specialized support services.
· Inclusion is the meaningful participation of children with developmental disabilities in the same range of home, early childhood and community environments, experiences and activities as other children.
· An inclusive environment or program is one in which all children, regardless of ability or background, are able to participate in all activities of their choosing.
· From the family perspective, inclusion is defined as the active involvement of families of children with developmental disabilities in the same range of community environments, experiences and activities as other families.
· An inclusive community environment or program is one in which all families, regardless of their abilities or backgrounds, are able to participate in all activities of their choosing.
Early childhood inclusion embodies the values, policies, and practices that support the right of every infant and young child and his or her family, regardless of ability, to participate in a broad range of activities and contexts as full members of families, communities, and society. The desired results of inclusive experiences for children with and without disabilities and their families include a sense of belonging and membership, positive social relationships and friendships, and development and learning to reach their full potential. The defining features of inclusion that can be used to identify high quality early childhood programs and services are access, participation, and supports.
In other words, inclusion means providing appropriate accommodation and support so that each child can participate to the fullest of his or her developmental abilities. Inclusion requires acceptance and compassion, and a commitment to creating a culture of belonging for all children and their families.
We all need a sense of belonging and to feel included. This is the essence of inclusive child care—that every infant and toddler feels like an important and accepted member of the group. Inclusive practices benefit everyone in the group.
Early intervention supports families
Delays in communication and language development are often the first sign of developmental problems in young children. When we identify concerns in communication and language development, we encourage families to seek intervention as soon as possible. Early diagnosis and treatment for developmental delays increases the chances of improvement rather than simply “waiting it out” and treating problems later.
Earlier is better
Treating communication and language difficulties early on can prevent potential problems with behavior, learning, reading and social interaction. Recent research on brain development reminds us that “earlier IS better” when teaching young children. By age 3, most of the major brain structures are mature, and it becomes more difficult to make significant changes in a child’s growth and development.
Early intervention provides parents with resources, supports and information to enhance their child’s communication skills. Working together with a provider trained in early child-hood enables parents to feel confident that they are facilitating their child’s communication development.
When communication and language are delayed, understanding and interacting with other children will also be delayed. This makes it difficult to develop friendships, solve problems and learn to negotiate conflicts. Through early intervention, children learn how to use language to convey messages, to express feelings and to interact with their friends.
Children with delayed communication development may get frustrated and exhibit challenging behaviorsto compensate for their delays. It is difficult to express wants and needs when communication is delayed so often a physical response such as biting or hitting takes its place. Intervention will provide supports and strategies to facilitate your child’s communication needs.
Communication development sets the stage for literacy and influences later success in school. There is evidence suggesting that having a good command of language goes hand-in-hand with the ability to imagine and to create new ideas and, eventually, to read and write.
Early intervention will help families add supports into everyday activities that they do with their child. This provides lots of opportunities for children to learn — not only when playing but also when getting dressed, brushing teeth, preparing meals, eating, bathing, helping with family chores, getting ready for bed, and lots of other activities. Intervention also brings the family a greater understanding of their child’s needs and how to break learning down into small steps for their child. When children know what they are expected to do and can be successful, they have fun learning in almost any activity, and want to learn more.