Early Intervention

Therapeutic services provided from birth to age three.

Early intervention programs provide children from birth to age three with therapeutic services designed to prevent disorders that may stem from genetic conditions or adverse circumstance and to ameliorate developmental delays at as early a point as possible. Down syndrome, cerebral palsy, cleft palate, and hearing and vision impairments are all conditions identifiable at birth or soon thereafter. Children with any of these conditions—or any combinations of them—are typical of the children referred to early intervention programs. Other children, who may not have such obvious conditions, may be referred because of significant delay in speech, language, motor, or cognitive development —often by the pediatrician or a community-based screening program.

Children begin early intervention with an assessment by members of a multidisciplinary team. Composition of the teams may vary, but often include an early childhood education specialist, a speech-language pathologist, an occupational therapist, a social worker, and a health care provider.

School districts often administer programs, typically in a multi-district collaborative arrangement. Other programs may be based in hospitals, clinics, or community centers. There are several, often overlapping, models of service delivery.

Center-based programs bring infants and children in for group sessions that often involve teaching stimulation strategies to parents, and promoting interaction among young children. Depending on the needs of the child, a classroom component may be offered. Home visits may supplement the center-based care to allow providers to assess the needs of the child and family in their own environment and to promote transfer of skills from the center to the real world.

Home-based programs offer support and teaching in the infant's home. Teachers, nurses, therapists, social workers, or some team combination of these, make weekly visits to the infant and family to provide suggestions and model behaviors that encourage stimulating and responsive parent-infant interaction.

Some early intervention programs are aimed at reducing social stresses that might lead to negative consequences for the child in families who are at risk (e.g., infants born to young adolescent mothers) or who have a history of negative parenting (e.g., abusive parents). Teaching parenting skills, educating parents about child development, and providing a support network for parents who face daily multiple stresses have been shown to be effective in enhancing family functioning and child development.

A central feature of early intervention programs is the involvement of both parents and infants or young children. Children born with seriously handicapping conditions may need remedial and preventive services for their own skill development, but parents also need support and guidance in understanding their child's condition, identifying ways of dealing with consequences of the condition at home, and coping with their own feelings of loss, guilt, or helplessness. Once intervention has been successful with parents, they are better able to nurture their child's optimal development, not just in a weekly visit, but through the everyday experiences of living.