Early Intervention

Early intervention (EI) is best seen as a system of multidisciplinary services designed to support those family interactions that enhance optimal development of children ages birth to three years. The benefits of such a system include remediating existing developmental difficulties, preventing the future effect of these difficulties, alleviating potential delays, limiting the development of additional handicaps, and promoting improved family functioning. These goals are accomplished by providing a wide array of therapeutic and developmental services for children, coupled with instruction and support for families. EI serves children with difficulties deriving from established disabilities (Down syndrome, autism, visual/aural impairments, etc), as well as environmental risks (disadvantaged families, maltreating parents, low-birth-weight child).

The history of EI is closely tied to federal legislation for special education services. With the passage of Public Law 94–142, Public Law 99–457, and subsequent legislation, and the implementation of the Individuals With Disabilities Education Act (IDEA), educators were made more aware of the special needs of infants, toddlers, and their families. Part C of IDEA (Program for Infants and Toddlers with Disabilities) is a federal grant program that aids in establishing and overseeing a comprehensive program of EI services for children birth to 36 months of age. Each individual state is responsible for creating a comprehensive early intervention system. One part of this system is the establishment of a comprehensive Child Find System. This system is a continuous process planned to locate, identify, and refer young children with disabilities to intervention services. The system also includes activities to increase public awareness of available services, and screening and evaluation of eligible children.

Originally, all programs were child-centered, with parents only playing peripheral roles. First the child was assessed for specific handicapping conditions, and then assigned to a multidisciplinary team of service providers including, but not limited to educators, social service personnel, speech and language clinicians, occupational and physical therapists, psychologists, and nurses. The parents were responsible for keeping all appointments and for continuing remediation programs within the home. Positive outcomes were seen as the extent to which parents learned and carried out the intervention activities that they were taught.

As a greater understanding was developed between families and service providers, it was realized that the needs of young children could only be truly appreciated in the context of their families. The focus of EI then shifted from the child as a single entity to the child within the family and the family within a total social context. Children's development is now viewed as being closely related to the environment within which the child is developing, namely, the family. As the family influences the development of the child, so does the child shape the development and dynamics of the family. Present models of EI are family-centered with emphasis on the family's strengths rather than deficits.

Cultural traditions play a very strong role in all family interactions; therefore, this role cannot be [Page 182]ignored within the context of the EI program. Cultural views of disabilities are extremely varied, and the parents' view of what constitutes an area that is acceptable for change and what is not can be difficult to understand before first considering cultural views. For example, within the rigid hierarchical structure of some societies, the deference that is paid to experts can easily be mistaken for trust. Parents may acquiesce to the recommendations of experts within the context of the conference, but may not follow through with activities that are dissonant with their cultural beliefs. By understanding the cultural background of the child's family, EI professionals can better design programs that will be helpful and acceptable to both child and family.

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