EARLY INTERVENTION-

Exploring The Child

PRESENTATION BY:-
SUDHANSHU PANDEY
 WHAT’S THAT-?
 Early intervention is the introduction of planned
programe deliberately timed &arranged in order to
alter the anticipated or projected course of
development. [Siegal-1972]
 It is a program which is broadly refers to wide range
of experience & support provided to children’s family,
parents during pregnancy, infants &early childhood
period of development.[Dunst-1995]
 The term Early Intervention refers to services
given to very young children with special
needs, generally from birth until the child
turns 3. for this reason these programs are
something called “birth to 3” or” zero to 3”
services include speech therapy, occupational
therapy ,physiotherapy either in an office or in
the child’s home. The hope is that these
services provided early ,will address any
delays in development so that the child will not
need service later on
 We are passing through an era which has seen rapid
changes in the concept of child and is barging ahead
taking strides in understanding normal child
development. There is mounting evidence documented
regarding the deleterious effects of disability
&handicapping condition on the normal development
of a child. It is aiso a known fact that these effects
can be minimized or prevented if children can be
identified who are at risk or have a disability or a
handicapping condition through “EARLY
INTERVENTION” programs. Thus early intervention
programs can be Preventive ,Curative& Remedial.
 NATURE OF POPULATION REQURING
EARLY INTERVENTION-
1. Biological risk-This includes Downs
syndrome, mucopolysacridoses, Fragile X
syndrome, Spinabifida, Hydrocephalus and
metabolic disorders like phenyl
ketonuria,Albinism.
2. Environmental risk-
 preterm term babies , post term babies,

L.B.W, malnutrition,infectious diseases

such as rubella.
 Children prenatally exposed to drugs-They
include children born to parents caught in the
cycle of drug ediction, self named

{children of alcoholics},infants born with

neonatal withdrawl as results of appropiate
exposure in utero, and individual with fetal
alcohol syndrome(FAS).
 Children of parents with low I.Q are at
increased risk for maltreatment
,developmental delay, learning disability and
behaviour disorder.
3. Established developmental delay –example
C.P Developmental delay occurs when
children have not reached the
 Mile stones by the expected time period. It can occur in all five
areas of development or may just happen in one or more of
those areas.
 Warning signs of a developmental delay
 There are several general "warning signs" of possible delay. These
include:
 Behavioural Warning Signs
 Does not pay attention or stay focused on an activity for as long a time
as other children of the same age
 Focuses on unusual objects for long periods of time; enjoys this more
than interacting with others
 Avoids or rarely makes eye contact with others
 Gets unusually frustrated when trying to do simple tasks that most
children of the same age can do
 Shows aggressive behaviors and acting out and appears to be very
stubborn compared with other children
 Displays violent behaviors on a daily basis
 Stares into space, rocks body, or talks to self more often than other
children of the same age
 Does not seek love and approval from a caregiver or parent
 Gross Motor Warning Signs
 Has stiff arms and/or legs
 Has a floppy or limp body posture compared to other children of the same age
 Uses one side of body more than the other
 Has a very clumsy manner compared with other children of the same age

 Vision Warning Signs

 Seems to have difficulty following objects or people with her eyes
 Rubs eyes frequently
 Turns, tilts or holds head in a strained or unusual position when trying
to look at an object
 Seems to have difficulty finding or picking up small objects dropped on
the floor (after the age of 12 months)
 Has difficulty focusing or making eye contact
 Closes one eye when trying to look at distant objects
 Eyes appear to be crossed or turned
 Brings objects too close to eyes to see
 One or both eyes appear abnormal in size or coloring
 Hearing Warning Signs
 Talks in a very loud or very soft voice
 Seems to have difficulty responding when called from
across the room, even when it is for something interesting
 Turns body so that the same ear is always turned toward
sound
 Has difficulty understanding what has been said or
following directions after once she has turned 3 years of
age
 Doesn't startle to loud noises
 Ears appear small or deformed
 Fails to develop sounds or words that would be
appropriate at her age
 RATIONALE OF EARLY
INTERVENTION
 A number of experts have highlighted the importance of early
childhood period. We all are aware of the extra ordinarily
rapid growth & development in the first few years of life.
 75% of brain growth is completed by 2years of age.
 Myelination is almost completed by 2years of age.
 Most of the gross motor and a great extent of fine motor
milestone are reached. The child is independently moving
about, exploring, manipulating& at the same time learning
and acquiring knowledge
 In 7-36 months most of young children acquire the ability to
understand most of the language they will ultimately use in
ordinary conversation throughout their lives.
 Personality traits are also stabilized by the age of 2.

 Neuroplasticity of the brain is at its peak in early years.[it is

the ability of brain to modify its structure& function depending
upon the demands from the environment.

 First phase of cognitive development occurs in 0-2 years.

 It is observed to be the period of unprecedented growth,

second only to the prenatal period. Developments occurs in all
the areas to a great extent & are shaped by environmental
influences.

 0-3 years is a critical period. Critical period in development

are those sensitive periods when the child is most susceptible&
responsive to learning experiences.
 IMPORTANCE OF EARLY
INTERVENTION
1. Screening and identification of at risk baby:-Early interventionist is
Trained to screen & identify the risk babies as early as possible.
This time can be at birth as in case of down syndrome, or VLBW
cases.

2. Enhancement of normal development:-Early interventionist takes

care that a Baby moves correctly on the development pathway.
Hence facilitateThe normal development by using various
techniques such as N.D.T.

3. Independent functioning:- Early intervention improves the

Independent functioning by helping the children in lacking area.
4. Prevention of secondary handicaps:- Prevents secondary
handicaps or Complications such as Tightness, Contracture etc.

5. Counseling the parents:- Early interventionist counsels the

parents & Encourages them to continue the therapy as it takes a
long time & Parents get frustrated easily by their child daily
problem & by Comparing them to normal child.

6. Cost effective:- Early intervention is very economical, it decreases

the burden on parents pocket by detecting & treating the
condition.
Early intervention services may be delivered in a
variety of settings, such as the child's home,
public or private agencies, a community
provider, a clinic, daycare, hospital or local
health department. To the maximum extent
appropriate, services are provided in
natural environments. Natural environments
are where the child lives, learns and plays.
 EQUIPMENT NEEDED
 Bolster
 Physio Ball
 Prone Wedge
 Hand activity table
 Parallel Bar
 Corner Chair
 Balance board
 Swing
 Equipment Needed

BOLSTER PHYSIO BALL

PRONE WEDGE PARALLEL BAR
Is Early Intervention Really Effective?
The Individuals with Disabilities Education Act in the
US includes provision for infant and toddler
programs (referred to as Part C), expanding the
availability of early intervention services for very
young children and their families. The US
Department of Education reported that about 189
000 children aged 0-35 months were receiving early
intervention services in 1998. Although each state is
required to compile program data . implementation
has been variable and the first published study
reporting state-wide early intervention service
delivery patterns appeared this year
Critical Features in Early Intervention
 While there have been too few attempts to
determine critical features of effective early
intervention programs, there are a few factors
which are present in most studies that report
the greatest effectiveness. These program
features include: (a) the age of the child at the
time of intervention; (b) parent involvement;
and (c) the intensity and/or the amount of
structure of the program model.
 BENEFITS
Benefits can be divided into 3 parts.
 To Hospital
 To Patients
 Social Benefit
 Benefits to Hospital:-
 Once established in an hospital patient will not move from one hospital to
another for the different treatment.
 Early intervention increases the strength of the hospital.
 Early intervention is economical.
 A survey conducted by NIMH shows that now a days about 30 to 40
percent preterm shows sign of developmental delay which is ahuge
population. so early intervention can be beneficial to normal weak babies.
 Since therapy will be on regular basis so it will generate a huge revenue
for hospital .
 As a lady becomes pregnant there are number of professionals who takes
care of her health and baby. but there is a missing link which can screen
and help the baby to develop normally at an early age. this can be make
compulsory for every preterm. since prevention is better than cure and we
follow it in other cases also .eg in polio by taking vaccination.
 Benefits to Patients
 Decrease the time & money wastage which
parents do by moving from one hospital to
another.
 Enhance the development of the child in an
normal way.
 Early intervention has no side effects.
 Social Benefits
A third reason for intervening early is that
society will reap maximum
benefits. The child's increased developmental and
educational gains and decreased dependence
upon social institutions, the family's increased
ability to cope with the presence of an
exceptional child, and perhaps the child's
increased eligibility for employment, all provide
economic as well as social benefits.
METHODOLOGY
 Objectives-
 The main objective of the study is to know the effectiveness of
Regular Physiotherapy in habilitation of children with
Developmental delay in Early Intervention.
 Sample-
 In this study, a group of 30 children with spastic
Developmental delay were taken. The age group of all
children was between 0-5 years. These 30 children were
divided into two different groups, where they were given
different kinds of physiotherapy treatment at different
intervals.
 Number of children taken- 30
 Gender-Male and Female
 Age Group- 0-5 years
 Type of Developmental delay- Spastic 
 Treatment Span-12 months
  Number of treatment session given-

 Group 1: (Regular Physiotherapy) - 288 

 Group 2: (Non Continuous Physiotherapy) – 48
 The children were randomly divided into two groups.
 Group 1: (Regular Physiotherapy) – The first group consist
of 15 children. In this group, the children were given regular
Physiotherapy treatment six days in a week.
 Group 2: (Non-Continuous Physiotherapy) – The second
group consist of 15 children’s. In this group, the children were
given Non-continuous Physiotherapy treatment ones in a
week.
Statistical Analysis
 Table I
Regular Physiotherapy
S. No Pre-test Post-test Difference

1 2 0 2

2 2 1 1

3 1 0 1

4 1+ 0 1

5 3 2 1

6 3 1 2

7 2 0 2

8 2 1+ 1

9 1+ 0 1

10 3+ 2 1

11 2 1 1

12 2 1 1

13 1 0 1

14 2 0 2

15 1+ 0 1+
 Table II
Non- Continues Physiotherapy
S. No Pre-test Post-test Difference
1 3 3 0

2 3 2 1

3 2 1+ 1

4 1+ 1+ 0

5 3+ 2 1

6 2 1+ 1

7 1+ 1+ 0

8 2 1+ 1

9 3 2 1

10 3 3 0

11 3+ 3 0

12 3+ 2 1

13 3 2 1

14 2 1 1

15 1 0 1
CASE STUDIES
Krithik is a 14 month old male child. The baby is preterm with a history of
Delayed birth cry & L.B.W .the baby can stand with support.
Diagnosis:- Developmental Delay with visual deficit.
Mannat is 15 month old female child with history of I.U.G.R, delayed birth cry
and L.B.W.Currently she is learning to stand with support.
Diagnosis-Global developmental delay.
A case of 23 month old female child. The baby had a history of preterm and
low birth weight Currently the child is sitting with support.
Diagnosis-Global Developmental delay.
 reeeeeeeee

Aarti is a 5 yr old female child. The baby had a history of Delayed Birth Cry &
L.B.W .Currently Aarti can sit with support.
Diagnosis:- Global developmental delay.
CONCLUSION
THANK YOU