Early intervention programs and strategies
1-Children with developmental delay
This group of children sometimes placed into the first category, which is common as we mentioned, others consider it as a separate category depending on the occurrence of developmental delay the child already have in the first two years of age in two or more areas of growth. here psychometrics and clinical test can be used. And in case the child gets degrees between one to two as standard deviation below average on standardized measure of growth , it considers an evidence of developmental delay, the clinical test, however, depends on a multi-disciplinary team that uses a variety of sources and judge the relevance of the developmental abilities of the child
Early intervention and disability:
There are several reasons that calls for the need for early intervention programs to help children with disabilities. These justifications are not stem from emotional sources toward these children, like sympathy or pity or even love, but it depends on the human growth theories that define the factors that facilitate or impede the growth of children, and the research in various fields, such as the characteristics of these children, and the impact of early deprivation arousal, or the direct benefits of early intervention programs on the child, family and community, and other research focus on the importance of the early years of age. and due to the multiplicity of these justifications we will review the most important eight of them as contained in the publication heritage. (Hanson & Lynch, 1995, & Peterson, 1987)
.1- Early intervention and disability:
Early Learning is the basis of subsequent learning, most of developmental theories confirms the close relationship between the early years and the subsequent growth and learning. The time that passes between the child’s birth and joining him in school, has special clue on human growth where the core learning styles and behavior are formed, which lays the foundation for all subsequent growth areas. When a child does not acquire completely habits and cognitive skills that are prerequisites for the new learning, this learning will be delayed and will be ineffective and incomplete, and in some cases impossible to be achieved. That learning is based on learning, and therefore weakness in any stage leads to the biggest weakness in the next stages, means the negative effects become cumulative. If the child was significantly delayed of his peers in some areas of growth, it means that that in order to join at a later stage he must accelerate learning in faster speed than the normal speed, that is, by starting immediately in the early intervention program.
Results of studies indicate the existence of a critical or sensitive periods to learn, and the early years of age is considered the most important stage that includes critical periods. The critical period is the time that certain stimuli or private experiences occur and submitted so that certain pattern of responses shows. During this time the child is more susceptible and responsive to learning experiences, and environmental stimuli be more powerful in calling certain responses or in the production of certain learning patterns , and thus learning takes place more quickly and easily.
While we are still talking about the critical periods, we must mention that the lack of expertise or proper arousal during growth periods , regardless of the reasons, it will lead to the child’s failure to learn the response and lose of the ability to acquire it later, or delay in acquiring the response time thereafter, where skill may be possible acquisition, but less efficiently and less spontaneously. Although learning may be appropriate to happen after the critical period for the acquisition of skills intended, but the arousal required to achieve the same achievement must be deeper and longer long. The question that arises here is: What are the possibilities the regular environment provide this kind of stimulation to the child who is bigger than this skill or respond?
As long as the critical period passed without achieving the desired learning target, it indicates a lack of adequate or inadequate environmental stimuli available to the child. In other words, the child acquisition and his mastery of needed developmental skills will not happen without a special Enrichment Program is available through the Early Intervention
The human intelligence and other potential abilities are not exist at birth, but they are widely shaped by environmental substances and through the learning process. Environmental factors are the active forces in shaping the nature of every human being, which includes physical care and nutrition, child-rearing methods, quality and quantity of existing arousal, emotional climate at home, educational opportunities to learn of the child. If there is anyone who believes that intelligence is immutable 3,
and the human traits fixed forever since born, so the early intervention efforts become useless. But luckily there are hundreds of field and Consecutive studies mainly about intelligence and other features prove the occurrence of change 4, either increase or decrease as a result of environmental factors. The most important of these factors in relation to intelligence, for example: the level of parental education, and how to encourage academic achievement, availability of educational experiences inside and outside the home, the cognitive environment in the family. Besides, there are also those experimental studies which have transferred some of the children from family environment which is poor in learning opportunities and put them in a cultural environment that provides adequate arousal, or improve environmental conditions through educational programs. The results of these pilot studies generally suggest the possibility of a child’s intelligence has changed for the better as a result of the experimental variables used
The handicapping or hazardous conditions affecting young child can hinder growth and learning to the point where the original deficit may become more severe, or they may show a child’s minor disabilities. Deficit could hamper the normal learning processes by blocking some familiar methods of interaction with the environment. If we let regular educational opportunities available to children without disabilities, so children with disabilities are more likely to be learning less adequacy of their peers. If they participate in life’s experiences (5) and take advantage of them in order to acquire basic skills, it would necessarily require some form of intervention and assistance.
For children with specific disabilities that have been diagnosed, the clear and apparent deficit (such as cerebral palsy or visual impairment), and some of the effects of these disabling conditions cannot be avoided, such as hearing disability that reduces the ability of the child to learn through auditory method. These disabilities creates an urgent and pressing need for early intervention as the effects on behavior and learning are clear and can be observed
For children who grow up under biological and / or environmental conditions ,there is possibility they might have future disability, or they will have developmental problems when they grow up so we must not wait until these children grow up to see what will happen then intervene if necessary. The problem is that simple deficiencies in growth can accumulate and turn into a disability, and when the child problems become severe and can be diagnosed and named the child may actually be suffering from the negative effects.
The question here is: Can we risk leaving the child’s growth under dangerous conditions to see whether a serious problem will appear, or whether we must intervene early to prevent this from happening as much as possible?
The quality of the child’s environment and the quality of the initial experiences have a significant impact on growth and learning, and on the child’s ability to achieve and exploit all his potentials and abilities. the quality of the environment and experiences Is determined by the availability of diverse arousal and different situations, its factor of particular importance for children with disabilities, because it helps in determining to what extent will shift the deficit to disability, and to what extent would disrupt the normal growth processes, (6) and to what extent can these children get the means to do educational activities that are usually available to ordinary peers
Studies show that the best environment for a child is providing him:
(A) The three types of sensory, emotional and social stimulation
(B) stimulation that support the development of verbal growth,
(E) to encourage problem-solving skills and the ability for exploration,
(D) the effects of positive results for his verbal reasoning (Peterson. 1987). Also Many studies results revealed that the deprived environments lead to abnormal behaviors and developmental delays among children, and if the transmission has happened to these children to an environment which provides the early and deep arousal , this can alter patterns of abnormal behavior. Among the most famous of those series of studies are Spitz studies (Spitz) and Goldfarb (Goldd) in the forties and fifties of this century which were performed on infants who were brought up in shelter institutions.
Early intervention programs can make a difference occur in the developmental progress of young children, in a way faster than the late treatment, which starts when the child enroll in schools. It also reduces the likelihood of the emergence of secondary disabilities in children, and increase the opportunities to acquire developmental skills that will be delayed or not learned.
There is a set of evaluative researchs on the long-term effects of early intervention programs, which are divided into three types, namely:
(A) early historical researches about transmission of mentally retarded children (7) or children with developmental delay from their poor environment to more stimulated environment, or the submission of additional forms of stimulation in their natural environment
(B) research on enrichment early education programs or therapeutic intervention programs with children from families with low income rate or living in inadequate environments
(C) assessment studies directly to the results of early intervention programs for disabled children
the importance of early intervention for disabled children is not less the importance of parents and all family members. Because the relationship between a young child’s behavior and the behavior of his parents is a circular relationship. When a child becomes a burden. And at the same time, the mother / father is more responsive and has more skill as a teacher and mentor, the child becomes more likely to gain developmental and adaptive skills, the parents of disabled children have many special needs that could be met by early intervention programs(8), including:
(A) to provide support for parents during the period when their suffering about the child disability is sever. During this initial phase , their attitudes and new patterns of interaction with the child are shaped.
(B) To assist parents in gaining the necessary skills to deal with the expected regular needs for their child with a disability. Parents may not be able to perform properly their role to rear the child because of lack of information in those regards , or Trapped under great pressure as a result of the many heavy burdens required to raise child with a disability, or because they lack the necessary support and assistance systems.
Wood (In: Peterson, 1987) has analyzed the economic benefits of early intervention in a number of evaluation studies. It calculated the total special education costs until the child reachs the age of 18 years and comparing these costs in case of commencement of special education services at birth, and at the age of two years, and at the age of six years. It turned out that the annual cost average of $ 2021 if the services started since birth, and $ 2310 if it started at the age of two years, and $ 4445 if it started at the school. And then the total services at the age of 6 years up to $ 46.816, or $ 53.340 if the child remains in a special class until the age of 18 years. This means that early intervention can save about $ 16.00 for each disabled student throughout his study services years
Early intervention programs:
the seventies has seen a proliferation in the early intervention programs, most of which have been depend on a Deficit model , which assumed that the weakness exists within the child and that the inappropriate environmental factors is merely contributing factors, and assuming that this weakness is the responsibility of parents in first class. Therefore, the programs focus on compensation education, and to return success to the efforts of the teacher and the failure to an imbalance in the family. Then a gradual shift among researchers happened in the eighties that reject the previous model (9) as a result of the emergence of what is now called the science of Special Education science,
And the emergence of social cognitive concept which is looking to the developmental growth as Transactional process, and its appearance was the end of the traditional separation between cognitive development and social growth, and recognition of the changing context of the experiences of the child (Sandows, 1990). If we review samples of the the early intervention programs currently used to choose the best model must be followed by all the programs, we will not find the model that is approved by researchers and specialists
On the contrary ,they reach consensus that there is nothing so-called the best program , , and no theoretical concept is more effective than others. The choice of effective program model is determined by values, educational philosophy, and developmental theory, which researcher tend to adhere to. . so we will review the basic theory trends in growth and learning, and how to apply each of them in the early intervention programs, both in terms of the objectives, curriculum content and teaching methods.
Theory and its applications:
1. Operant Behavioral direction:
Supporters of behavioral trend believes that a child’s growth occurs through interaction with the environment of the child based on the principle of stimuli- response, and this interaction gives the child opportunity to learn how to understand relationships between stimuli and responses and actions carried out, and the results of this (reinforcement and punishment).
As this trend also assumes that all human behavior is an educated and learned behavior. And educational failure happens when children do not acquire the basic specific skills which allow him to learn other skills. To learn those basic skills should be taught to children, because they do not appear automatically. So learning can be accomplished by specifying a precise target behaviors and arrange convenient stimuli that can invoke the required responses, and program learning in small and sequential steps, , with the need to strengthen the desired responses.
Curriculum content here does not follow the logic of the growth stages, but it is using therapeutic or functional behavioral in the selection of the skills that are learned. And th main selection criteria that the skills to be suitable for the child’s age, and meaningful, and it has a direct interest. The teaching strategies used depend on the direct teaching, such as modeling ,prompt, shaping , sequencing and reinforcement. And teaching is individualized based on an initial assessment of the basline behavior of the child. The intervention program based o that direction has interest in building a program, planning and careful organization and strict from all aspects, and full use in many of the early intervention programs.
Developmental trend goes to that child will learn when he is ready developmentally to learn, meaning that he will automatically learn developmental skills needed in well-organized environment. And that this learning takes place through successive stages of each manifestation of growth. The first programs in the early intervention depend of this trend, its goal was to help young children with disabilities to grow through the normal stages of growth. Those enrichment programs have been emerged in the sixties to provide special services for children living in deprived family circumstances.(10)
Curriculum content in the early intervention program consists of different skills that represent aspects of growth that a child needs to acquire, those skills are identified, according to the stage of the child development and their own skills. and curriculum content is sequenced according to certain stages. And the role of intervention specialist is negative here, he has to work on the availability of the appropriate materials and activities suitable of the child-developmentally-, who in turn choose what he wants to participate in it. Teaching strategies thus trying to be the types of activities carried out by non-disabled children, and the theoretical principle here is that these activities provide an opportunity for the disabled child to practice important growth objectives at each stage.
he development of this form of cognitive developmental trend in early intervention, which was based on Piaget’s theory of cognitive development.
Curriculum content is similar with developmental curriculum content, but with a focus on cognitive skills, relying on the skills sequence, described by Piaget in the sensory motor stage and pre-processes stage.The teaching methods used in developmental cognitive model also relies on Piaget’s theory, where early intervention specialist display tasks that evoke a child’s challenge to create a state of unbalance, so organization and adaptation occurs while trying child to face the challenge, and then the balance is achieved and learning happens and specialist practicing active role in encouraging the child to try new activities and ask him about his experiences he is going through, but the specialist does not intervene to prevent the failure of the child
Environmental direction considered the child is behaving according to his environment, and he gets better learning through direct experience ,and that through direct interaction and processing of the environment the child grows and becomes more skilled than doing the basic developmental skills, resulting in his progress towards higher levels of cognitive competence. Child’s early interaction are primarily live experiences, but with the physical growth of the child its replaced by a more complex forms of interaction with the environment. The child begins to merge experiences using symbols to represent these experiences or ideas, and he uses language as an intermediary in the organization of experiences. Cognitive processes begin to appear when the child can discover the concept of relationships and uses them in a complex interaction with the environment.
Curriculum content in early intervention programs which based on the environmental concept is determined on an individual basis for each child to reflect the natural environment demands of those who are in the same age level, and the content is changed with the child’s growth. When there is divergence between the level of readiness of the child and the appropriate skills for his age ,the curriculum content is adjusted to fit the child abilities and needs. It is required to have the skills necessary for the child’s participation in the present and future environments ,one of the main aspects of the Early Intervention Program to organize activities that provide the child with: direct experience, experimentation, learning through exploration (11) and active participation. And learning is easier if the cognitive level of the child sufficiently equal to the type of experience he experiences.
Teaching strategies to be used are vary, and comes on top of it the Incidental teaching. This method uses the behavior of the child to determine the attitudes and circumstances in which they are teaching, aimed the strengthening of the independence and equality of the child. The context in which teaching occurs is a characteristic of this model, the natural environment for the child is the source from which it derives its content, and at the same time it is teaching environment (Noonan & McCormick, 1993)
the activities trend is the trend, which currently has the utmost care in the field of early intervention. Bricker presented for the first time in 1989, and quickly caught the eye and spread its use in many programs (Hanson & Lynch, 1995)(12). Theoretical roots of this trend depends on four well-known theorists ideas, and they are Skinner , Piaget , Figo tesken and John Dewey. The trend-based activities based on three main concepts, namely: –
(A) the effect of the interaction of both direct social context and the public on the child’s learning and development,
(B) the need for the active participation of the child to ensure a good and efficient education,
(C) activities and experiences offered to children must have meaning and function of his point of view (Bricker &
There are four key elements of the existing early intervention program based on activities, namely: –
(A) Taking care of child’s motives and interests and actions through encouragement on the proactive activity, and participation in the activities of his choice. A child has leadership in guiding the activities whenever possible, and therefore less need for reinforcement.
(B) merging training and learning in a child’s routine activities for the integration of the targeted skills that directly benefit him in the natural context. And the introduction of learning in the activities planned by the specialist so that raises the child’s attention and considers it fun for him.
(C) getting benefits of the routine or planned activities does not guarantee occurrence of the required changes in a child’s skills, it only offers a rich and natural context for intervention procedures, and then has to be systematic use of pre- and post-stimuli that occur as consequence by logical activities. A child does not leave playing so that hopefully the learning takes place, but a specialist to act as an effective participant.
(D) the targeted skills in the early intervention program must be functional and generating Generative. Functional skills are those that allow the child to deal with the social and physical environment independently and in a way that is satisfied for him and the others around him. As we help the child to acquire generated skills help him in the independent interaction in different situations, meaning , not teaching the child to respond to certain signals under certain conditions, but teaching him to generalize all sorts of skills
Typical framework of early intervention programs
Each institute has its own model of the early intervention program commensurate with its intellectual framework and long-term objectives of this intervention. Any intervention program must be:
components of Program model for therapeutic intervention
The frame model for the early intervention program consists of eleven component provides a complete description of the program in terms of content and priorities of teaching, application strategies, materials and facilities, and expected results. Among these components, there are three components represent a basic rule where the remaining components are placed above, and the set of values or philosophies as well as the theoretical orientation determine the background concepts that decisions are taken in based on it, and from these two components long-and short-term goals are extracted, It is the third component (14).
These objectives determine the imposition of the model program and what he wants to achieve for the child and his family and the community. The other seven components dealing with the internal characteristics of the program and mechanisms of action. And on each of them to determine how to translate the values and objectives and theories in the actual practices when providing services to children and teach him. The following is a brief description of the components of the program model
(B) values about education, such as what is the role of education in the community and its responsibilities towards children with disabilities or at risk? What we want to achieve with the child in special education?
(C) values on the educational process, such as how to define what should be taught to the child? What are the limits of the role of both teacher and child in the actual educational practices?(15)
(A) pattern emphasizes on the skills, both basic developmental skills (such as language, movement and self-help) or academic skills (such as reading and arithmetic).
(B) pattern emphasizes on the cognitive processes – conceptual, such as thinking skills and problem solving.
(C) emotional-cognitive pattern, in terms of objectives focused on trends, experience and personal attributes.
What is the nature and limits of the role of the teacher in the classroom? What is the nature and limits of the role of the child in the classroom? What is the nature of the learning process in: daily schedule, the children’s assembly rules, the degree of construction and organization of activities and the use of materials?
Methods of services delivery:
In The Education Field , the term of Service delivery is used , meaning the administrative arrangements which used to deliver educational assistance for children with special needs. these methods where known in light of the quality of the spatial context in which its introduced (inclusion class, a special class, resources room, daycare school, inside the house). this trend force researchers and professionals to focus attention on the issue of where the child should be attached more attention to the issue of what should be provided to the child from this place. then special education must offers something special, something extra and unusual than provides in the normal class(18)
Dunn Suggested (In: Peterson, 1987) four types of arrangements patterns the professionals can use to help students with special needs, and Dunn focuses on the components of special education program, describes the services in the light of what must be characterized by special education,
These patterns are: –
(1) professionals specially trained to work with children with disabilities or at risk.
(2) a special curriculum content to replace the normal curriculum or supplemented.
(3) methods of teaching especially to facilitate learning and troubleshoot learning problems.
(4) special materials and equipment provide support and assistance to the process of learning.
The problem with the first direction that cares about the place and the second direction that cares about the content, that they do not focus on the importance of effective and practical procedures that will enable them to reach services.
So turning from the term of “providing service” to another term focus on practical Process. this definition Confirms on the strategies and activities used in providing special services, including planning for all the steps or the following operations: who will receive the services, when to start and how long it lasts, what are the services provided, where it will be provided, who will serve, what are the responsible authorities (Peterson 0.1987).
Because the common methods in providing services currently still follows the traditional method, these methods will be classified according to the pattern of the place where special services are offered. The methods are divided into two groups, methods that provide services within the child’s home (Home – based) and the methods offered through the Center (Center – based), noting that some centers are using both types at the same time (Bryant & Graham, 1993).
A – Support the child’s Family:
supporting the child’s family is an important component in all methods of providing the service, as the parents are the nearest persons in a child’s life, and their participation in the early intervention program is important to achieve better results. (19) The main types of support offered to the family are: information about the child’s development and learning opportunities, routine and emergency care for children, medical care for the child and the provision of medical equipment and materials, training for parents on health approaches to child-rearing, economic support, information and facilities concerning the resources of entertainment, means of transport, the necessities of life food, clothing.
B – a family visit programs:
families visit programs provide families of developmentally or physically disabled children, The most important reasons for the visit to provide support for parents and teaching them parental skills, and reduce the level of stress the family live. Most programs use techniques such as modeling of positive interaction between the child and adult, teaching appropriate learning activities to child needs (Roberts & Wasik, 1990). (20) There is contradiction in the results of researches on the effectiveness of family visit programs, (Bryant & Graham, 1993).
Especially that the rate of repeated visits, the researchers do not agree about it. For example, it has been shown that the non- repeated home visits for the families of severely disabled children it was more successful than repeated visits to medium term, but in the long run less successful (Sandows, 1990)
2-ways to provide services within the center:
the Ways to provide special services within the center based on that the family bring the child in an early intervention program in one of the centers where they provide the services required by professionals. The intervention on an individual basis or a small number of the group, and most curriculums tend to use the developmental and therapeutic models. The most important kinds of these ways are:
A – Mother–Child centers
in These centers the mother spends 6-20 hours a week, where she is attending meetings of mothers and child development classes, and workshops about resources exist in the local community, also she interacts with her child. Usually in the centers ,a team from different professions available to deal with the diverse needs of the child and the family.
B – Child development daycare centers:
The perfect form of the Child development care is the educational care by trained personnel, and the small number of the classes has the suitable environment for the child –developmentally-. Benefit from this children with simple or medium. disabilities.
(C) Reverse inclusion centers:
It is centers prepared basically for children with special needs, and their children attend the ordinary, to be accounted for at the center is the least. Centre deals with moderate to severe developmental needs, it also offers substantial support for the family in relation to the needs of the child.(21)
D – kindergarten:
It is for children with special needs in the age of 3-5 years. It is either a kindergarten for disabled children only, usually involving various types of disability. And it is committed to the regular school system (six hours a day in school).
The scheduling of quotas on the basis of the growth areas, and with a quality of activities designed to meet the needs of children. Families are not involved enough, as there is no proper support. The second format is integrated kindergarten, which includes normal and those with special needs children. In this kindergarten professionals and semi-professionals have specialized in early childhood, with a special education specialist. The curriculum focuses on learning concepts or on the subject of activity, with an emphasis on appropriate educational practices suitable – developmentally- to the child.
Best practices applied currently in the Early Intervention:
1. Family-centered intervention and not a child with special needs
2. rely on the environmental /functional direction in determining the content of the curriculum through the analysis of the child environments characteristics, and teaching by moving away from rigid and highly organized methods
3. integration, ie providing services in natural environments for children
There is a consensus among researchers about the importance of early intervention, and the proven benefits of intervention programs for children with a disability or at developmental risk, and for his family. But the reality is not so. The published scientific heritage has many of the contradicted results and unconfirmed allegations. (Robson, 1989)
Many researchers pointed out that the long-term results of early intervention is uncertain, and that the immediate effects of the programs begin to gradually extinction within a few years. In 1985, the White Casto White & Casto analyzed 316 articles published in the United States describing and / or evaluatiing an early intervention programs for children in biological and / or environmental conditions. It was the most important thing they reached that most of the results of the assessment studies presented by the proportion of children’s intelligence data.
In addition there are a number of studies have shown that many of the children born in a biological or medical risk can heal without therapeutic intervention. For example, it has been shown that about 30% of the newborn who came out of intensive care in need of some forms of therapeutic intervention at the age of six years, while 70% of them will not need to do so. (Hanson & Lynch, 1995)
Other studies have also indicated that many children with developmental delay, especially the mentally retarded due to environmental deprivation, may show compensatory growth in the teenage years so they become less and less disabled, and also show a compensatory physically growth(Brown, 1991)
However it is not clear at all why this delay in the growth is occurred, may be due to the presence of biological mechanisms delay the biological clock when there is an environmental deprivation in early childhood, and compensation in the cognitive domain needs to wait several years to receive a wide range of environmental stimuli so make sure that the basic cognitive structures can evolve
We have to deal with these previous image with caution and do not approve its validity ever for the following reasons:
Quality life ( Goode , 1994 ) . )
(A) This image relates basically to young children who live in biological and / or environmental conditions, and not to children who have been diagnosed of disability (B the effectiveness of the intervention program is mainly based on the measurement of child’s intelligence, (Goode, 1994). )
(C) the lack of studies, which focused on the effects of early intervention programs on family, compared to the numerous studies about the child.
(D) Developments in the past few years in the field of early intervention avoided a lot of drawbacks and shortcomings that existed. The most important of these developments is centering around the family and not the child and environmental/functional perspective
(E) the previous image was based on studies and research conducted in the Arab community because the United States society is a society which has its own culture that is different from our Islamic Arab culture, which has a direct reflection on many aspects of special education. (Brown, 1991)
In spite of all this, most researchers agree that if early intervention programs were not available, many of the children who has biological and environment threat may become in the future with a disability, so it should be avoided by working to increase the spread of early intervention programs services
The successful and effective model for early intervention program should take into account three important issues, may strongly influence the achievement of the program objectives. These issues are:
A – taking care of determining moderation factors that affect the family pressures.
(B) taking into account the practical and physical needs of the family.
(C) detecting and identifying methods of coping used by the family in treating the impossible problems that cannot be overcome.
The field of early intervention in the Arab Gulf countries needs to be more recognition and appreciation by those responsible persons for social welfare, and more attention and study by researchers and workers in special education. Perhaps the remarkable experience of Sharjah City for Humanitarian Services in early intervention be an motivation to repeat this experience, after evaluating its results, in other countries.