Early childhood intervention


Early childhood intervention is a support and educational system for very young children who have been victims of, or who are at high risk for child abuse and/or neglect as well as children who have developmental delays or disabilities. Some states and regions have chosen to focus these services on children with developmental disabilities or delays, but early childhood intervention is not limited to children with these disabilities.
The mission of early childhood intervention is to assure that families who have at-risk children in this age range receive resources and supports that assist them in maximizing their child's physical, cognitive, and social/emotional development while respecting the diversity of families and communities.

Definition

Early intervention is a system of coordinated services that promotes the child's age-appropriate growth and development and supports families during the critical early years. In the United States, some early intervention services to eligible children and families are federally mandated through the Individuals with Disabilities Education Act. Other early intervention services are available through various national, regional, and state programs such as Crisis Nurseries and Healthy Start/Healthy Families America. 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 aid with the below through the services of physical, occupational, and speech therapy. Some examples include:
  • Help prevent child abuse and neglect
  • Mitigate the effects of abuse and neglect
  • Improve parenting skills
  • Strengthen families
  • Improve the child's 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 successful, independent individuals.
  • Assistance with technological devices, counseling, and family training.
The earlier children at high risk for abuse or neglect and children with disabilities receive assistance, the likelihood for both short term and long term benefits to occur increases. Short-term benefits of early intervention include primary school readiness, increased learning and school performance, better health and nutrition, as well as a safer and more supportive home environment. Long term benefits of early intervention include reduction in instances of crime, drug use and teen pregnancy as children grow into adolescents and young adults.

History

Early childhood intervention came about as a natural progression from special education for children with disabilities. Many early childhood intervention support services began as research units in universities while others were developed out of organizations helping older children.
Early childhood education has roots in legislation reaching as far back as 1966 with the Elementary and Secondary Education Act. The legislation provides federal funding to primary and secondary education. The act emphasizes equal access to education, aiming to shorten the achievement gaps between students by providing federal funding to support schools with children from low income families. A more modern form of this act is the No Child Left Behind Act passed in the early 2000s. Then only a few years after the Elementary and Secondary Education Act, the Handicapped Children’s Early Education Assistance Act of 1968 was passed which established 75 to 100 programs to support preschool aged children that are disabled.
Further, in 1972 the Economy Opportunity Act of 1964 was amended to extend Head Start programs. Head Start programs started as services to support children from low income families,  the amendment extended the services to support children with disabilities. Head Start programs are the foundation that early childhood intervention was built upon.
In 1975, the Individuals with Disabilities Education Act was passed. This was landmark legislation that guaranteed free, appropriate, public education to all students regardless of ability. IDEA is the legislation that guarantees early childhood education programs to children and families.
In the 1990s, 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 or county, depending on the state.

Individuals with Disabilities Education Improvement Act (IDEA) Part C

The Part C 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. The therapies provided by IDEA can be found in the home, child care, early head start, and community settings such as the county. 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. Other factors, not commonly cited but often experienced are language delays due to factors such as deafness, autism, learning disabilities, or severe psychosocial issues.
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. As states and federal territories 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.

Meeting developmental milestones

Every child is unique, growing and developing at his or her own rate. Differences between children of the same age are usually nothing to worry about. However, 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.
Identifying these delays early is also important because the most critical time for brain development is before the age of three. The brain develops in an experience-dependent process. If certain experiences are not triggered, the pathways in the brain relating to this experience will not be activated. If these pathways are not activated, they will be eliminated.

Milestones birth to three

At age one month most children can:
  • Raise their heads slightly when lying on their stomachs
  • Briefly watch objects
  • Pull away from a blanket on their face
At age three months most children can:
  • Lift their heads and chest while lying on their stomachs
  • Make cooing sounds
  • Follow a moving person with their eyes
  • Smile back at someone
At age six months most children can:
  • Sit with minimal support
  • Roll from their back to their stomach
  • Respond to their name by looking
At age 12 months most children can:
  • Pull themselves up to stand and take steps with hands held
  • Follow with their eyes in the direction in which a person are pointing
  • Start a game of peek-a-boo, imitate clapping hands, point to show a person something
  • Say two or three words on a regular basis
  • Sit up when prompted
At age 18 months most children can:
  • Walk backwards
  • Walk down stairs holding an adult's hand
  • Use words and gestures to get needs met
  • Perform simple pretend play like talking on the phone, feeding a stuffed animal
At age 24 months most children can:
  • Kick a large ball
  • Describe an injury or illness to an adult
  • Show interest in other children by offering them a toy or taking their hand
At age 32 months most children can:
  • 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
However, if a child is premature it is not correct to compare them to this list of developments to be achieved by the age of three. The chronological age of a premature child needs to be considered. That is, if a child is 12 weeks old but was born four weeks early, then the child's chronological age is only eight weeks. This is the age that needs to be considered when comparing the child's developments to others.
Recent discovery has also suggested that in some premature children the delays do not appear until the age of three, suggesting that all premature children receive early intervention therapy rather than just those who appear to have developmental delays.