Good Practice: Early Intenvention

Early Intervention

Organisation   Theotokos Foundation
Country Greece
Short description The goal of the program is to support the inclusion of as many children as possible in mainstream kindergartens and elementary schools, by providing intensive intervention from an interdisciplinary team, both on site in group and individual programmes and off site with integration support.

Activities
The integration program is individualised, based on the child’s needs. The type and frequency of support the integration aide provides is adapted according to the level of stress the child experiences when confronted with the new environment and the amount of behavioural, cognitive or social difficulties presented. The support provided is also adapted according to the kindergarten teacher’s needs, [which can range from just a few visits followed by telephone communication to full support of the child].
Ongoing support is provided to the kindergarten teacher and the parents even after the child is fully integrated in the kindergarten.
Disability awareness-raising activities are conducted at childcare centres, kindergartens, schools, community services, professional seminars and conferences.

The activities leading up to and during integration ensure a smooth transition from the special service to the mainstream service, increase the likelihood of successful integration of the child and overall decrease the number of children at risk of needing further special education during their schooling. 
Target group
  • 2.5 to 4.5 year old boys and girls are admitted with diagnoses such as developmental delay, immaturity, language disorder, ADHD, Autistic Spectrum Disorders or learning difficulties. The service does not care for children with physical disabilities. The children must have a valid diagnosis from a government service. 
  • The children’s parents should have social security but this is not mandatory as a certain number of children from poverty stricken families are admitted per year.
On an annual basis, 12 children are admitted. One of our aims is to increase the number of children participating in our programme. 

Underlying theories
International research has shown that Early Intervention for preschool children reduces the need for special education and treatment during the school-age period.

Within the framework of a bio-psycho-social model, individualised programmes are created based on the child-centred approach using principles from developmental, cognitive and behavioural theories.
A transdisciplinary approach is applied, providing intensive individual programs and small group programs (6:1 student-to-teacher ratio).
Empowerment of the parents through active engagement in therapy sessions.
Mainstream inclusion principles such as the use of an integration aid are used as well as gradually increasing the number of attendance days and gradually decreasing the amount/type integration support provided until full inclusion is achieved.
Stakeholders
involved
Family members

Family members are oriented to the service during the initial intake procedure. A thorough case history is taken and information about the current situation is obtained by the social worker and child psychiatrist and/or developmental pediatrician. The family members are informed about the program in general.

Once the child has enrolled and attended the program for a short while, the interdisciplinary team prepares the Individual Education Program (IEP). The parents attend a meeting with the interdisciplinary team where the strengths and needs of the child are discussed as well as the structure and functioning of the service. The parents are informed about the goals on the IEP and are welcomed to participate in this procedure.

Parents are actively involved in their child’s daily program through the use of a communication book in which both the parents and the teachers/therapist exchange written information about the child’s activities, progress and any other concerns. The teachers and therapists also prepare home activities to encourage parent participation and to ensure carryover of skills learned into the child’s life.

Parents attend training and counselling sessions with the teachers or therapists. The training usually involves the presence of the child so as to improve the parent-child relationship and to empower the parents to support their child’s development and generalisation of skills in their home environment.

When the interdisciplinary team assess that a child has acquired the necessary skills to begin kindergarten integration, the parents attend a meeting to discuss the child’s progress and the integration procedure. The kindergarten is contacted and the days of attendance confirmed. Parents are supported throughout this procedure as it is usually a stressful time for them considering that their child is leaving the supportive early intervention program and entering a kindergarten classroom where he/she will be one of 25 children.

The service’s integration support worker is responsible for informing the parents about the child’s progress at the kindergarten.

In collaboration with the kindergarten teacher and the parents the days of attendance are gradually increased and the integration support decreased.

Once the child has become integrated full-time into the kindergarten, parents are still able to contact the service with any concerns they have.

The service also provides support to parents by providing information on afternoon therapy centres that may be needed or on recreational programs available in their neighbourhoods.

Community partners

  • Collaboration with referral sources such as public diagnostic centres and hospitals.
  • Collaboration with local childcare centres in conducting screening assessments.
  • Collaboration with mainstream schooling heads such as principals and district counsellors.
  • Collaboration with a neighbouring infant and child orphanage (Mitera Centre)
  • Integration int mainstream kindergartens and primary schools near the children's homes.

Direct impact  
  • Number of children enrolled in the programme.
  • Number of individual intervention goals achieved.
  • Length of time in the on-site programme before the integration program begins.
  • Frequency, type and amount of support needed for the child to be fully integrated into the mainstream kindergarten (i.e. 5 days per week)
  • Number of children successfully integrated into the mainstream schooling system.
  • Satisfaction rates from the Parent Satisfaction Questionnaires.
  • Satisfaction rates from the Kindergarten Teacher Satisfaction Questionnaires.
  • Feedback results from government agencies which also assess the children’s progress.
  • Results from Follow-up studies of past students regarding the continuation of their progress in the mainstream schooling system.
Conclusions and results
People with difficulties are entitled to receive the same or even better educational opportunities as all other members of society. By communicating and cooperating with local schools and communities we benefit society by raising awareness about children with mild difficulties and the programs that support their integration into the general education system. Early Intervention for preschool children reduces the need for special education and treatment during the school age period.
Unfortunately, some mainstream teachers and specialists have difficulty in accepting change and in acknowledging the value of supported integration programs thereby not allowing the presence of our integration support aide in their classrooms. Meetings have been held with School District Counsellors in order to raise awareness about disability and to foster better communication and understanding of our program. Awareness raising activities have to continue in order for parents and pediatricians to overcome the stigma associated with children attending special education settings. 
Duration
and Milestones

2000: Commencement of the Early Intervention programme

2002: Cooperation with local government organizations and referral sources

2003: Early Intervention programme presented on Theotokos Foundation's internet site

2005: Annual funding granted through the Johnson & Johnson Corporate Citizenship Trust (this allowed one extra staff member to function mainly as an integration support aide)

2006: Commencement of the kindergarten integration program

2007: Cooperation with the local childcare centres’ and kindergartens' principals as well as meetings with the Ministry of Education's District Counsellors.  

2010: Simulation of kindergarten conditions in the classrooms

2010: Application of the TEACCH model in the classrooms

2010: Presentation of the Early Intervention Programme at the  EPR Annual Conference in Athens

2013: Two hundred brochures were sent to neighbouring paediatricians, childcare centres and kindergartens in order to promote earlier detection and raise awareness.

2014: Collaboration with all the Child Care Centres in the Municipality of Ilion in order to raise awareness, to strengthen networking and to formalize the identification and referral process.

2014: Presentation of the Early Intervention Programme at the Pammakaristos Day Conference

2014: Grant from the Hellenic Initiative USA

Throughout the years there has been frequent participation in continuing education in order to improve practice (eg.training in approaches such as Sensory Integration, Floor-Time, SCERTS, ABA).

Contact/More information  Speech Therapist - Vaia Arsenopoulou: varsenopoulou@theotokos.gr