Early childhood intervention for children with developmental disabilities

Early childhood intervention is a support system for children with developmental disabilities or delays and their families.

The mission of Early Childhood Intervention is to assure that families who have children ages birth to three, with diagnosed disabilities, developmental delays or substantial risk of significant delays receive resources and supports that assist them in maximizing their child's development while respecting the diversity of families and communities.

Definition
Early intervention is a system of coordinated services that promotes the child's growth and development and supports families during the critical early years. Early intervention services to eligible children and families are federally mandated through the Individuals with Disabilities Education Act.Starting with a partnership between parents and professionals at this early stage helps the child, family and community as a whole.

Early intervention services delivered within the context of the family can:


 * Improve both developmental, social, and educational gains;
 * Reduce the future costs of special education, rehabilitation and health care needs;
 * Reduce feelings of isolation, stress and frustration that families may experience;
 * Help alleviate and reduce behaviors by using positive behavior strategies and interventions; and
 * Help children with disabilities grow up to become productive, independent individuals.

The earlier children with or at risk of disabilities receive assistance and the sooner their families receive support towards their child's development, the farther they will go in life.

History
Early childhood intervention came about as a natural progression from special education for children with disabilitiesalnik, 1997). Many early childhood intervention support services began as research units in universities (for example, Syracuse University in the United States and Macquarie University in Australia) while others were developed out of organizations helping older children.

In the 1990s, the many States in the US put into place a program where the child's pediatrician can recommend a child for early childhood intervention screening. These services are usually provided free of charge through the local school district.

Individuals with Disabilities Education Improvement Act (IDEA) Part C
The Part C (originally Part H) program mandates a statewide, comprehensive, multidisciplinary service system to address the needs of infants and toddlers who are experiencing developmental delays or a diagnosed physical or mental condition with a high probability of an associated developmental disability in one or more of the following areas: cognitive development, physical development, language and speech development, psychosocial development, and self-help skills. In addition, states may opt to define and serve at-risk children. Commonly cited factors that may put an infant or toddler at risk of developmental delay include low birth weight, respiratory distress as a newborn, lack of oxygen, brain hemorrhage, infection, and prenatal exposure to toxins through maternal substance abuse.

Every state now implements Part C fully. The original legislation provided a five-year phase-in period for states to develop their comprehensive system of service for the affected population. Although IDEA does not mandate states' participation in Part H/C, powerful financial incentives from the federal government have led every state to participate. States were provided extensions of the 5-year period as they struggled with the logistic, interagency, and financial demands of developing a statewide system. To ensure a coordinated approach to service delivery and financing of services, federal regulations of Part C require that states develop interagency agreements that define the financial responsibility of each agency and impanel a state interagency coordinating council to assist the lead agency in implementing the statewide system. Regulations also prohibit the substitution of funds and reduction of benefits once the plan is implemented in each state (U.S. Department of Education, 1993). As states and federal territories (for example, Guam, Puerto Rico, the Virgin Islands) began to plan for implementation of P.L. 99-457 and later IDEA, their first obligation was to designate an agency that would provide leadership in the planning and administration of the state's comprehensive system. In 1989, 22 states or territories had the department of education as lead agency, 11 others had the department of health, another 9 had the department of human services, and the remaining states had combined departments or departments of mental health or developmental disabilities (Trohanis, 1989).

Meeting Developmental Milestones
Every child is unique- growing and developing at his or her own rate. Most of the time differences between children of the same age are nothing to worry about. But for one child in 10, the differences can be related to a developmental delay. The sooner these delays are identified, the quicker children may be able to catch up to their peers.

Milestones Birth to Three
At age one month most children can... At age three months most children can: At age six months most children can: At age 12 months most children can: At age 18 months most children can: At age 24 months most children can: At age 32 months most children can:
 * Raise their heads slightly when lying on their stomachs
 * Briefly watch objects
 * Pull away from a blanket on their face
 * Lift their heads and chest while lying on their stomachs
 * Make cooing sounds
 * Follow a moving person with their eyes
 * Smile back at someone
 * Sit with minimal support
 * Roll from their back to their stomach
 * Respond to their name by looking
 * Pull themselves up to stand and take steps with hands held
 * Follow with their eyes in the direction that you are pointing
 * Start a game of peek-a-boo, imitate clapping hands, point to show you something
 * Say two or three words on a regular basis
 * Sit up when prompted
 * Walk backwards
 * Walk down stairs holding an adult's hand
 * Use words and gestures (like taking you by the hand) to get needs met
 * Perform simple pretend play like talking on the phone, feeding a stuffed animal
 * Kick a large ball
 * Describe an injury or illness to an adult (bumped my head)
 * Show interest in other children by offering them a toy or taking their hand
 * Pretend to be an animal or favorite character
 * Talk about the past/future
 * Answer "what", "where", and "who" questions easily
 * Imitate drawing a horizontal line after being shown
 * Hold a crayon with 3 fingers

Early Intervention Services
The following is a list of what early intervention can provide.


 * Assisting technology devices and services - equipment and services that are used to improve or maintain the abilities of a child to participate in such activities as playing, communication, eating or moving.


 * Audiology - identifying and providing services for children with hearing loss and prevention of hearing loss.


 * Family training - services provided by qualified personnel to assist the family in understanding the special needs of the child and in promoting the child’s development.


 * Medical services - only for diagnostic or evaluation purposes.


 * Nursing services - assessment of health status of the child for the purpose of providing nursing care, and provision of nursing care to prevent health problems, restore and improve functioning, and promote optimal health and development. This may include administering medications, treatments, and other procedures prescribed by licensed physician.


 * Nutrition services - services that help address the nutritional needs of children that include identifying feeding skills, feeding problems, food habits, and food preferences.


 * Occupational therapy - services that relate to self-help skills, adaptive behavior and play, and sensory, motor, and postural development.


 * Physical therapy - services to prevent or lessen movement’s difficulties and related functional problems.


 * 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.


 * Service coordination - someone who works in partnership with the family by providing assistance and services that help the family to coordinate and obtain their rights under the Early Intervention Program and services agreed upon in the IFSP.


 * Social work services - preparing an assessment of the social and emotional strengths and needs of a child and family, and providing individual or group services such as counseling or family training.


 * Special instruction - includes designing learning environments and activities that promote the child’s development, providing families with information, skills, and support to enhance the child’s development.


 * Speech-language pathology - services for children with delay in communication skills or with motor skills such as weakness of muscles around the mouth or swallowing.


 * Vision services - identification of children with visual disorders or delays and providing services and training to those children.

Providing Early Childhood Intervention
Robin McWilliam (2003, 2010 ) developed a model that emphasizes five components: Understanding the family ecology through eco-maps; functional needs assessment through a routines-based interview; transdisciplinary service delivery through the use of a primary service provider; support-based home visits through the parent consultation; and collaborative consultation to child care through individualized intervention within routines. "These services are to be provided in the child's natural setting, preferably at a local level, with a family-oriented and multi-dimensional team approach".

Early childhood intervention may be provided within a centre-based program (such as Early Head Start in the United States), a home-based program (such as Portage in Britain), or a mixed program (such as Lifestart in Australia). Some programs are funded entirely by the government, while others are charitable or fee-paying, or a combination of these.

An early childhood intervention team generally consists of teachers with special education training, speech and language pathologists, Physical therapists (physiotherapists), occupational therapists, and other support staff, such as music therapists, teacher aides/assistants, and counselors. A key feature of early childhood intervention is the transdisciplinary model, in which staff members discuss and work on goals even when they are outside their discipline: "In a transdisciplinary team the roles are not fixed. Decisions are made by professionals collaborating at a primary level. The boundaries between disciplines are deliberately blurred to employ a 'targeted eclectic flexibility'" (Pagliano, 1999).

Goals are chosen by the families through the annual or biannual Individual Family Service Plan (IFSP), which evolves from a meeting where families and staff members talk together about current concerns, as well as celebrating achievements.

Criticism
Criticism of Early Childhood Intervention asserts growing up is different in detail for each individual, depending on genetic endowments and environmental circumstances. But one thing is common to everyone: the process, in order to take full advantage of the species' potential, must be natural ripening, uninterfered with by clumsy intruders. Thence, criticism of Early Childhood Intervention adduces no one shall push healthy children to learn any skill or academic discipline before they choose to do so of their own accord.