Poonthalir - early intervention programme

Early Intervention support needs to be given to children who have delays in developmental milestones or disabilities during their formative years of 0 to 5 years. The American Academy of Pediatrics recommends that children be screened for general development using standardized, validated tools at 9, 18, or 30 months and for autism at 18 and 24 months or whenever a parent or provider has a concern. Studies say that more than 200 million children under 5 years of age in developing countries do not reach their developmental potential. The Persons with Disabilities Act, 1995 has been passed to ensure equal opportunities, protection of rights and full participation for Persons with Disabilities, chapter IV of The Act deals with prevention and early detection of disabilities. 

Children found with development delays need supports in skill development including 

• Physical skills (reaching, crawling, walking, drawing, building), 
• Cognitive skills (thinking, learning, solving problems), 
• Communication skills (talking, listening, understanding others), 
• Self-help or adaptive skills (eating, dressing), 
• Social or emotional skills (playing, interacting with others). 

This period is very crucial for children because nearly 95% of brain development happened in this period. Early diagnosis and support services are very important during this period. Early intervention helps children to improve their delayed milestones ultimately which improve children enrolment in schooling. Children who have developmental delays or disabilities need services like Physiotherapy, Occupational therapy, Speech therapy and Special Education for improving cognition, Activity for Daily living, adaptive skills and Social and Emotional Skills.

The Covid-19 Pandemic has made the children with disabilities more vulnerable, particularly for the children who require early intervention services. It is vital for families to have access to services that support early childhood development. Early intervention services are more crucial but the services are not affordable to all kinds of people. While the families from upper income group could get support services from privately available sources, the households from poor and downtrodden communities could not access such services from the public healthcare facilities. They were restricted by lock-down and lack of transportation. 

 Availability, accessibility, affordability are the 3A’s determine any social, economic or health intervention at the community level. With the paucity of therapists, lack of institutional arrangements and its penetration to the last-mile-last-post, it is unfair to expect a poor family in the remote rural or tribal area to access the institutional services forgoing their employment and wages. Whereas, an affluent family in the towns or cities can reach such services and even they are ready to spend considerably for the early intervention. 

Community based extension approach for home-based rehabilitation has proven its effectiveness among the poor families, who have limitations to access professional care and support. FEATHERS in association with the Amar Seva Sangam, has designed a community based early intervention programme. Trained care-givers under the guidance of rehabilitation professionals undertake home visits and assist the mothers to continue home-based interventions in a fixed periodicity. It has proven its suitability for the locations, where the parents are poor and unable to spend on rehabilitation and could not forego their daily wages and travel to towns and cities to access professional rehabilitation services. In this Community Based Intervention model, all the children who are in need of early intervention could get services at their home itself  with the direct involvement and participation of their parents, which is very crucial for home-based follow-up to realise rapid improvement.