Unit 4: Early Identification and intervention

4.1 Concept and need of early identification

4.2 Screening and referral

4.3 Involvement of parents and the community

4.4 Role of special teacher/ educator in Early Intervention and related matters

4.5 Models of Early Intervention- Home based and centre based

 

 

 

 

 

 

 

 

4.1 Concept and need of early identification

Early Identification refers to a parent, educator, health professional, or other adult’s ability to recognize developmental milestones in children and to understand the value of early intervention.

The earliest years of a child's life are critical. These years determine child's survival and thriving in life, and lay the foundations for her/ his learning and holistic development. It is during the early years that children develop the cognitive, physical, social and emotional skills that they need to succeed in life. The World Health Organization (WHO) states that early childhood is the most important phase for overall development. Factors like disability and malnutrition pose particularly difficult challenges. However, if these problems are solved at an early age, it minimizes developmental risks and enhances child development.

However as per guidelines of IDEA (Individuals with establishing the socio-demographic profiles & the Disabilities Education Act) of United States, "Early pattern of clinical features in children attending EIP. The intervention services are designed to meet the study also sought to assess the profile and expectations of developmental needs of children, from birth to three years people who attended the clinic with the long term of age, who have a delay in physical, cognitive, objective of modifying the program as per their needs. communicative, social, emotional or adaptive development or have a diagnosed condition that has a high probability of resulting in developmental delay"Individuals with (Disabilities EducationAct, 2001.

If children with developmental delays or disabilities and their families are not provided with timely and appropriate early intervention, support and protection, their difficulties can become more severe often leading to lifetime consequences, increased poverty and profound exclusion. Typical development is sometimes a struggle. Everyone likes to think that all babies will be okay, that parents will have nothing to worry about. But the reality is that not all babies will keep up, and some will continue to fall further and further behind. Science demonstrates that intellectual and cognitive potential is determined by how the brain develops during the first few years of life. The brain controls the biological effects of all the other organ systems and influences cognition, intelligence, learning, coping and adaptive skills, and behaviour. Because the brain controls these different aspects of human life, impaired brain function leads to impaired physical, mental, and emotional health and decreased functioning in society. Therefore, investments in early childhood to support healthy brain development help to reduce societal costs in remediation, health care, mental health services, and increased rates of incarceration.

There are a number of reasons for this early identification:

·        Early Identification leads to early intervention, which is considered essential in remediation.

·        The children have not yet faced academic failure therefore it becomes easier to work with them as they still retain their motivation to learn. 

·        At that young an age they have not developed the compensatory strategies, which will later form barriers in the remedial process. 

·        Research has shown that children who received assessment and remedial services at a younger age were better able to cope with the disability and had a better prognosis than those who received help later.

4.2 Screening and referral

Screening

Screening refers to the use of standardized assessment to identify delays in development that may indicate the need for further evaluation.

Screening is the first step in the assessment process. It is a fast, efficient way to identify students who may have disabilities and should undergo further testing. It quickly establishes for the assessor that the student may require the services of a professional who will then be able to administer the necessary measures to either diagnose or rule out the presence of a disability. Screening tools are often easy to administer and classroom teachers can be trained to use these effectively to collect the initial impressions and information.

Screening of students may result in either the conclusion that there may be no requirement of further investigation but adjustment of teaching or it may lead to a referral for further, more comprehensive assessment.

Though often they are a part of the same process it is important to distinguish between screening, evaluation and assessment.

“Screening (including developmental and health screening) includes activities to identify children who may need further evaluation in order to determine the existence of a delay in development or a particular disability. Evaluation is used to determine the existence of a delay or disability, to identify the child‘s strengths and needs in all areas of development. Assessment is used to determine the individual child‘s present level of performance and early intervention or educational needs”. [Boyle et al, 2011]

It is usually these teachers who do the screening through their informal measures including classroom tests. They are the ones that observe the students over a period time and can talk of a pattern of behavior, which is so important in the assessment process. Therefore it is appropriate to say that the assessment procedure requires input form both informal measures adopted by teachers for screening and tracking the progress of the student and the formal tests that firmly establish the diagnose and provide the standards for comparison.

Referral

 Referral is the initial request to consider a student for a special education evaluation.

It is usual for classroom teachers or parents to make the initial request. This is a follow up of observations over a period of time and collection of initial impressions about the student‘s performance that causes concern. Once a student has been identified by the classroom teacher as showing signs of disabilities, the process of referral is begun. The stages through which the process is completed are as follows:

4.3 Involvement of parents and the community

Parental involvement in a child’s education along with environmental and economic factors may affect child development in areas such as cognition, language, and social skills. Numerous studies in this area have demonstrated the importance of family interaction and involvement in the years prior to entering school.

Parental involvement may be different from culture to culture and society to society. Parental involvement may have different types, which might have differential influence on academic performance of their children. Parental expectations have a greater impact on student’s educational outcomes. Parental involvement may include activities like helping children in reading, encouraging them to do their homework independently, monitoring their activities inside the house and outside the four walls of their house, and providing coaching services for improving their learning in different subjects.

·        Parental involvement categorized into four broad strands;

·        Parental involvement in children’s school-based activities,

·        Parental involvement in children’s at home-based activities,

·        Direct parental involvement in academic activities of children and

·        Indirect parental involvement in academic activities of children.

It is true that parental involvement level vary among parents. For example mother parent of young children, educated or uneducated parents, father’s involvement, their economic status, family background, social environment. It is observed that parental involvement with children from early age has been found to equate with better outcomes specially in building their personalities parents are primary guides to them, children try to copy them, and considered them that they are always write so parents can shape their life as they can. Their involvement has positive impact on children academic achievement even when the background factor of such as social class, family size, has been taken into account.

Parents’ collaboration is not only of benefit for children: there are also possible gains for all parties, for instance:

·        Parents increase interaction with their children, become more responsive and sensitive to their needs and more confident in their parenting skills.

·        Educators acquire a better understanding of families’ culture and diversity, feel more comfortable at work and improve their morale.

·        Schools, by involving parents and the community, tend to establish better reputations in the community.

The role of a community towards the disabled individual can be easily elaborated if we emphasize on creating friendly relationships with pure intent and understanding. First of all — the importance of forming a bond has hence permitted the individuals to collaborate and empathize with the disabled individuals which thus automatically creates a sense of worth and belonging. In contrast, a distressed disabled individual won’t be able to be productive if he/she is left alone so therefore, building a connectivity bridge will lead to finding out the similarities and the differences of each and every individual within the community. 

The common ideology of all these platforms is to provide a sense of belonging for the disabled individuals where they can share their real life experiences online in a safe, comforting and friendly environment.

One of the major step towards a collaborative community is to be provided with trained teachers taking the responsibility of engaging the disabled individuals. The importance of a trained teacher is substantial in an inclusive education and the necessity of achieving better results by filling the space for the disabled individual with knowledge and a sense of recognition. The right training of the teachers should not be overlooked by the authorities but instead encourage the trainee/trainers to participate in professional development courses. Hence, teachers are the pioneers of a community in building a common ground for the individuals facing any disability. Thus, with their training, the disabled individuals can succeed and shine in any desired platform.

4.4 Role of special teacher/ educator in Early Intervention and related matters

Special educators

Teachers with a degree in special education are trained to work with children with special needs. There are even specializations within the field of special education for specific disabilities like learning disabilities. Special educators are trained to design IEPs, conduct informal assessments, identify children with disabilities, design intervention and deliver the remedial programme to the children. Schools may employ special educators, or they may work privately to help support children with disabilities.

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

Early Intervention

•      The introduction of planned program deliberately timed and arranged in-order to alter the anticipated or projected course of development.

            [Siegal -1972].

            Preventive – Primary, Secondary

            Curative – Treatment, Surgery

            Remedial – Aids & Appliances

            Alternative methods      

•      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

•      Screening

•      Identification

•      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

Role of the Special Education Teacher

 

4.5 Models of Early Intervention- Home based and centre based

In the field of disability, early intervenlion refers to planned and organized efforts to enhance the development of children, who have a disability or who are at risk of developing it. Typically, early intervention programmes focus on children from birth to six years of age.

The aim of early intervention is to provide the child with an environment that fosters his development in all areas; including language, cognitive (mental), behavioural, social and emotional. Thus, the objective is to minimize the negative impact of the impairment or the disabling condition on the overall development of the child, and the inter-relationships within the family. Early intervention thus involves:

(i) providing appropriate stimulation to the child with disability and carrying out individualized educational and therapeutic activities, and

(ii) providing necessary support, guidance, and training to the family.

There are different ways in which early intervention services can be provided. The services can be direct or indirect. When the services are provided by the professional or early intervention team member(s) directly to the child, they are called direct services. When they are provided to the parents or caregivers, who in turn work with the child, they are called indirect services. The services can be provided in the home setting, in a centre, or by adopting an approach that combines the two.

Home-based Intervention

This is a common method of providing intervention - the services are provided to the chiid and the family members at home. The professional intervener visits the house of the child with, interacts with the family members, and observes their routine, practices, cultural and social activities. She/he estimates the available resources in terms of family members, finances, and materials. This helps the professional to understand the background of the child with disability and his family. Also to find out the strengths and needs of the child. If the child needs any medical help, she helps to arrange for it. Her home visit may have been a referral from the Primary Healt , Centre, where the child's medical needs are being taken care of. In such cases, the home intervener helps to ensure follow-up of medical requirements, such as taking medicines on time. She also guides the family in getting the child's hearing loss assessed, and in the procurement of appropriate hearing aids. She evaluates the child to determine what skills and abilities he already has, and which are the ones that he is ready to acquire.

After understanding the family and its environment, assessing the child, and ensuring medical intervention (if needed) and the acquisition of suitable hearing aids, the home trainer focuses on the training aspect. She works with the parents to prioritize the training needs, and to plan the required training activities. Further, she demonstrates to the parents and other family members how to carry out the programme suited to the child's needs.

Having taught the parents how to do the various training activities with the child, the trainer makes periodic visits to the house in order to monitor the progress of the child and to help the parents with any problem. These visits could vary from one to three times a week, depending on the need of the family as well as mutual convenience. She also maintains a record, in simple form, of her assessment of the child, his progress, and the present activities being carried out.

Thus in the home-based intervention model, the parents become the child's primary teachers. This type of programme demands much of I parental time, dedication and motivation. Therefore, it is important for the home trainer to identify at least one other person at home, apart from the mother (for example the grandfather or aunt) who can give training to the child. Ideally, all family members should be involved and sensitized. Even brothers and sisters can be trained to give home-based training to the hearing impaired child. The siblings can be taught play way methods of providing stimulation to the child - they often do it more effectively than an adult!

Centre-based Intervention

This is a system where the parents take the child to a centre for children with disability, where training is provided to the child and often, to the parents as well. At the centre, a group of experts, including a doctor, audiologist, social worker, special educator, speech therapist, occupational therapist, and so on, attend to the child and train the parents and other caregivers to carry out tasks at home to foster the development of the child. These types of services are essential for children with multiple handicaps, for instance the deaf-blind, or deaf and mentally challenged, or deaf with cerebral palsy etc.

There are three ways in which the expert team at the centre may interact with -the parents and the child:

·         Each member of the expert team meets the parents and the child, and provides intervention.

·          The team of experts, collectively, attends to the child and the family and provides intervention.

·         All experts meet and discuss the child's case and one team member receives information and guidance from all of them and in turn interacts with the child and the family.

Any of these three ways of functioning or a combination can be found at a centre. Each of these ways of functioning of the professional team at the centre has its own strengths and limitations.