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Early Intervention Programs
The term early intervention (EI) programs refers to a mosaic of services and programs created for young children and their families to meet educational, social, and health needs and promote enhanced learning, social, and communication outcomes. EI programs are provided before a child starts school, sometimes beginning before birth and continuing to school age. A goal of EI programs is to reduce gaps in child development that are due to one or more of the following: poverty or welfare status, family violence, child abuse, lack of family housing or ability to parent, poor health, single parenthood, teen parenthood, low maternal education, lack of proficiency in the English language, disabilities, developmental delays, poor language or emergent literacy, and the presence of a variety of at-risk conditions. EI programs incorporate a range of approaches, including child-focused interventions, dyadic interventions between an infant and parent, and family interventions that include siblings, parents, and even grandparents. The Division of Early Childhood for the Council of Exceptional Children identified a list of 1,606 recommended EI practices based upon a review of empirical research in 48 journals of effective early intervention programs or approaches.
Over the past 35 years, three major areas of interest have evolved in the field of EI programs:
- Longitudinal experimental research of the efficacy of programs for children from birth to 3 years and preschool age
- The national establishment of programs to achieve ‘equity’ in education for children in poverty (e.g., Early Head Start and Head Start) and children with special health care needs or disabilities (e.g., Early Intervention Programs for Infants and Toddlers with Disabilities under Part C of the Individuals with Disabilities Education Act [IDEA] and Preschool programs under Section 619 of Part B, IDEA)
- Concerns for quality and accountability prompted by legislative mandates
This entry will briefly highlight recent research in each of these interest areas and provide additional background information on modes of service delivery in health settings, homes, and centers and the economic advantages provided by intervention services.
Prevention Efforts
Early intervention programs may have features that are universal or are intended for a broad population. All young children are in need of a medical home that will provide continuity of medical care with developmental screening and preventive health care in a family-centered context. Model programs such as Healthy Steps, a pediatric care intervention, provide anticipatory guidance through child developmental surveillance, promote positive health practices, and encourage parents to ask questions and express any concerns they may have regarding their child's development. This program has proven successful in increasing a child's access to well-baby care, because participating families tend to remain with a practice for longer periods, and in reducing negative parenting practices and allowing depressed mothers a safe environment to discuss their distress.
Prevention approaches can begin even before the birth of a child in the form of preventing or ameliorating the effects of conditions that may be caused by environmental, lifestyle choices, or other addressable conditions. A number of early intervention programs have been developed that target women in the neonatal period, particularly women with conditions that require extended hospitalizations. The Newborn Individualized Developmental Care and Assessment Program (NIDCAP), developed by Heidelese Als and others, has fostered new approaches to neonatal care, especially among premature infants. The NIDCAP approach trains neonatal staff to support premature infant regulation and appropriate development through individualized observation. Because of recent technological advances, very low birth weight (VLBW) premature infants have an improved survival rate but are at higher risk for adverse health problems and developmental delays; neonatal intervention approaches like NIDCAP address these issues. As the rate of premature births continues to climb, the development of effective interventions for the medically fragile premature infant is of increasing concern.
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