Benefits of Early Intervention
Early intervention refers to the provision of therapies to a child with Down syndrome, starting at a very early age, that will help address developmental delays that children with Down syndrome normally face, and help them achieve their greatest potential. By giving them a "headstart," it helps to minimize how far they fall behind their peers once they enter the school system.
Development is a process that begins before birth and proceeds in an orderly fashion through developmental "milestones" in each of four areas of development: gross and fine motor abilities, language skills, social development, and self-help skills. Each milestone is a prerequisite to subsequent milestones. There is a range of variability for attainment of individual milestones among children without Down syndrome, but in general children with Down syndrome tend to attain these milestones at a later age than the non-Down syndrome child. However, most importantly, they DO achieve these milestones in their own time!
Studies have shown (www.ptjournal.org/cgi/reprint/73/3/170.pdf) that early intervention has benefits continuing into at least early adolescence, but because early intervention has only been in practice for about 20 years now, we are only now seeing its effect on the potential of young adults with Down Syndrome. Our experience here at PREP shows that a combination of early intervention followed by inclusion has helped prepare many individuals with Down syndrome for a more included, self-sufficient, productive adult life.
Early intervention also offers many benefits to the parents. It can provide information, encouragement and support to new, overwhelmed parents. It can provide parents with exercises and activities that can be done at home with the child to meet their specific needs and enhance their developmental rate. Lastly, early intervention centers provide parents the opportunity to share their experiences and concerns with other parents and to benefit from the collective experience.
Early intervention Therapies
The most common early intervention services provided consist of: physiotherapy, occupational therapy, speech and language therapy, as well as any health care services required to deal with physical health issues such as vision, hearing or heart. These therapies, along with improved medical care, and increased parental and societal recognition of what individuals with Down syndrome are capable of when stimulated and challenged may explain why the new generation of individuals with Down syndrome are demonstrating better skills and higher levels of functioning than past generations.
Early Intervention in the Calgary Area
In the Calgary region, early intervention usually starts a few weeks after the child is born with weekly visits by an Early Intervention Worker from the Calgary Health Region. Up until about age 1, this worker assesses the child's development and provides simple exercises and aids to the parents to help stimulate their child's development. As well, the Alberta Childrens' Hospital Down Syndrome Clinic provides physiotherapy and occupational therapy services as needed.
After age 1, and until age 6, the child is usually enrolled in an early intervention program provided by a third party provider, such as the PREP Program. These providers provide the early intervention services (physiotherapy, occupational therapy and speech language pathology) at least until the child starts school.
Physiotherapy also known as physical therapy, focuses on motor development, generally gross motor skills. Because children with Down syndrome generally have low muscle tone, they will be delayed in achieving milestones such as head control or sitting. The physiotherapist can illustrate exercises that parents can do with their baby to help him or her achieve this milestone earlier than he or she might without this intervention. For the child to progress through the normal range of developmental growth in other areas, such as exploring his environment, reaching for and playing with toys, and to be an active participant in his or her environment, instead of a passive observer, the development of these underlying gross motor skills is important, and any additional delay in these skills cascades into delay in other developmental areas.
Occupational therapy generally deals with fine-motor skills, such as eye-hand coordination, oral-motor, and early academic skills, such as proper grasp of toys, pencils, manipulating fine objects, etc. Therapists also help children learn to feed and dress themselves, and how to play and interact with other children.
Speech and language therapy is a critical component of early intervention. Though speech is usually delayed in children with Down syndrome, the earlier they are able to use speech to communicate, rather than signs, the easier it is for them to communicate their needs to parents, teachers, and playmates. There are many pre-speech and pre- language skills that must be acquired prior to the development of speech, including the ability to imitate and echo sounds; turn-taking skills; visual skills; auditory skills; tactile skills; oral motor skills; and cognitive skills. A Speech Language Pathologist can provide exercises and games that the parents can do with the child to help develop these skills earlier than they otherwise would develop. Early repetition and reinforcement of these exercises helps the child develop the foundations for speech earlier than without this intervention.
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