Early Childhood Care: Comparison
Please note this is a comparison between Version 3 by Mario Grande-de-Prado and Version 2 by Mario Grande-de-Prado.

Early Childhood Care (ECC) can be defined as those actions aimed at children from 0 to 6 years of age, their families and the environment surrounding them, which seeks to provide a prompt response to permanent or occasional circumstances derived from some difficulty in their development or in a situation of risk of suffering them. To this end, it has to be taken into account the child in an integral manner, including all vital aspects: social, physical, emotional, etc. and will be des

 

  • Early Childhood Education
  • Family-centered approach
  • Intervention in the environment
  • Early Childhood Intervention
  • Early Childhood Care

1. Introduction

It is currently assumed that every action in Early Childhood Care(ECC) must be carried out with the family in mind and counting on their participation. It is necessary to establish an intervention not only with the children but also, with their surroundings and the whole family. Within this perspective, the Family-Centered Approach (FCA) stands out, which is defined as the association established between professionals and families, with respect, taking into account their values and decisions, offering support when needed, in order to achieve the optimal functioning of the family nucleus. This article aims to know what the perception of families and professionals is concerning Early Intervention 

Early Childhood Intervention is fundamental in the evolutionary process [1]. Any intervention in early childhood care (hereinafter, ECC) must take the family into account and count on their participation [1,2]. The role of the family has changed over time, gaining an active role.

ECC can be defined as those actions aimed at children from 0 to 6 years of age, their families and the environment surrounding them, which seeks to provide a prompt response to permanent or occasional circumstances derived from some difficulty in their development or in a situation of risk of suffering them. To this end, it has to be taken into account the child in an integral manner, including all vital aspects: social, physical, emotional, etc. and will be designed and implemented by a multidisciplinary team which will provide a multiple and as complete a response as possible [1].

2. Intervention

The three levels of intervention in ECC are [2]:

- Primary prevention: aimed at the child population in general, to avoid anything that could lead to a developmental difficulty, anomaly or disorder.

- Secondary prevention: more precisely, aimed at the child population at risk or sensitive to the presence of a disorder, trying to avoid the appearance of the problem, and if it does appear, to detect it and draw up an early diagnosis, to reduce its negative consequences.

- Tertiary prevention: aimed at children who already have developmental disorders, as well as their families and environment. It tries to minimize everything that the disorder entails.

Thus, its traditional targets are those who suffer from disorders caused by: "developmental, cognitive, motor, communication, sensory, behavioral and/or emotional disturbances", permanent or occasional [3](p. 34) and/or are in a situation of risk (biopsychosocial risk).

The aim of ECI is to offer its beneficiaries an intervention that facilitates their integration into society, promoting the achievement of the greatest possible personal autonomy. However, in a more specific way the objectives of ECI are [1]:

  1. To reduce the effects of an impairment or deficit on the child's overall development.
  2. To optimize, as far as possible, the course of the child's development.
  3. To introduce the necessary mechanisms of compensation, removal of barriers and adaptation to specific needs.
  4. To avoid or reduce the occurrence of secondary or associated effects or deficits caused by a high-risk disorder or situation.
  5. To attend to and meet the needs and demands of the family and the environment in which the child lives.
  6. Consider the child as an active subject of the intervention.

If one objective had to stand out above the rest [3], these would be: to promote child development without risks or obstacles and, if a difficulty is finally detected, to support families by offering individual attention in accordance with their needs.

3. Concepts

Early Stimulation, Early Intervention or Early Care are some of the terms used to refer to all those interventions designed to avoid or minimize the obstacles that children with disorders or considered to be at high risk may experience. Currently, the term ECI is considered to be the most appropriate from a globalizing and integrating point of view. It transcends [3] mere early stimulation, focused on achieving the speed of the child's normal development and early stimulation, where the environment in which the subject develops begins to be taken into account.

Another relevant concept is Family-Centered Approach. This concept (hereafter FCA), has considered that there should be a partnership between professionals and families, based on respect, taking into account their values and decisions, offering them support when they need it, in order to achieve the optimal functioning of the family nucleus [4].

4. History, milestones and leading figures

The precedent for FCA [5] can be found in Carl Rogers and his Client-Centered Model, but in the FCA, instead of the client, the focus was on the family. Another precursor in the 1970s is Brofenbrenner [4], who already emphasized the positive family influence on child development. In the 1990s, this approach would become paramount with three basic aspects: 1) focusing on strengths and not deficits, 2) promoting family control and decision making and 3) a true collaborative professional-family relationship.

Table 1 offers a brief review of the historical evolution of Early Care Childhood [3], and the key role of the families.

Table 1. Historical evolution of Early Care concept.

Early stimulation

(1970-1980)

Early intervention

(1980-1990)

Early care

(1990-2000)

Quality Early care

(2000-2010)

Socio-sanitary care

(2010 and beyond)

Child intervention

Child-family intervention

Child-family-environment intervention

Child-family-environment-society intervention

[1][2][3][4][5][6][7][8][9][10]

Intervention focused on people

Handicaps (0-2)

Handicaps (0-6)

General population

Universal Law (0-6)

Universal Law

 

It will be towards the 80s, when the traditional models of intervention (such as the behaviorist model of Watson and Skinner, based on the relationship between stimulus and response for behavioral modification, the clinical-rehabilitative model, whose origin was in rehabilitation services, pediatrics and maternity wards) will be left behind, but still focused solely on the child [6] or the psycho-pedagogical, which represents the beginning of ECC teams and the beginning of the importance of the family as an agent that enhances the child's development), when other models that are truly adjusted to the needs of the child and his or her family will begin to be chosen. Thus, according to Gútiez [6]:

  • Bronfenbrenner's Ecological Model, which highlights the existence of a set of influences in the child's environment that affect his or her development, including the family itself. Thus, it focuses on understanding and comprehending the individual from his or her closest and everyday environment.
  • Sammerhoff's Transactional Model: children develop according to their interactions and thanks to family and environmental experiences.
  • Feurstein's Interactive Model, which seeks to change or modify development through the correction of deficiencies.

In addition to these models, in the 1990s, Bricker and Cripe included a new one; the Activity-Based Approach Model. According to Caurcel [3], it takes into account the theories of Vygotsky, Piaget or Dewey, where the learning of skills and abilities is acquired in a real context with authentic problems or challenges. It is also based on three aspects: the influence and interaction of the immediate socio-cultural environment, the active participation of the learner and through meaningful and functional activities, there is an improvement in learning. Furthermore, it is worth briefly mentioning the Family Intervention Models [3]:

- Guralnick and his Early Development and Risk Factor Model, which takes into account: family patterns, family characteristics and potential stressors.

- Cunningham and Davis: who place the starting point for intervention with parents.

- Turnbull, Turbiville and Turnbull: reviewing the different models of family intervention and their evolution:

  • Psychotherapy & Psychological Help: All decisions and strategies are in the hands of the professional expert. The focus of intervention was the mother, ignoring the child and the rest of the family components. This model has now been superseded.
  • Training parents Valuing their capacity for intervention, and already seeing the need to involve them in the process. However, they required the instruction of the professional, being the one who made the decisions, oriented towards achieving changes in the children and not in the families. Parenting patterns has a huge impact on social attitudes [7]
  • Family-centered Progressively, the professional gives up his or her power, and simultaneously, the family acquires it, which is now an important part of the decision-making process.
  • Collective strengthening It goes one step further: if there is a correct relationship between family and professionals, the result will be an improvement in the social context making it more participatory and achieving changes and improvements at community level.
  • Strengthening families It starts from three clear premises: parental capacity, the need to promote experiences that give rise to suitable and capable behaviours and the attribution of locus of control to the families themselves.

Finally, there are common elements in all these models [1-4]: the social interactions of the child in his or her environment stand out, the child is an active subject, learning has to be acquired in a natural context, meaningful activities leading to an end are carried out on a daily basis, and reinforcement is natural. Thus, the selection of one model or another will depend on who intervenes, taking into account that each professional has a preference for one or other principles in the intervention, however, after some time, they will tend to syncretism, selecting the best and most effective of each of the available options.

45. Current status

Currently [1-4] all intervention must be carried out taking into account the family and with their participation. Therefore, once the need to establish an intervention not only with children but also with their environment and family is known, this dissertation focuses on the latter. Their role has changed: at the beginning of ECC, they were limited to assuming the professional's decisions about their child, where they complied with the measures designed by the expert and the family became a passive subject. Nowadays, this clinical-rehabilitative model has been abandoned and a more educational model has been adopted that takes into account family relationships as a tool to achieve the child's development.

The implementation of family-centered has been found to have positive effects on both the family and the child; the empowerment of families plays a crucial role in their achievements, influencing their skills and confidence in caring for and fostering their child's development. It also enhances their ability to recognize their rights and effectively utilize support networks and community services [8].

So, Early Childhood Intervention (ECI) is crucial for a child's development [9], and it should involve the family's active participation. ECI encompasses actions aimed at children aged 0-6, their families, and their environment, addressing difficulties in their development or situations of risk. The intervention should be comprehensive, considering all aspects of the child's life and implemented by a multidisciplinary team. There are three levels of intervention: primary prevention, secondary prevention, and tertiary prevention. The main objectives of ECI are to reduce the effects of impairments, optimize development, introduce necessary mechanisms for adaptation, prevent secondary effects, and address the needs of families and the child. Family-Centered Approach (FCA) emphasizes collaboration between professionals and families [10], focusing on strengths, promoting family control and decision making, and establishing a collaborative relationship. Over time, intervention models have shifted to consider the child's environment and the importance of the family.

References

  1. GAT. Libro Blanco de la Atención Temprana. [White Paper on Early Intervention] Real Patronato sobre Discapacidad. Retrieved from http://bit.ly/2WvBEUS, 2000.
  2. GAT. Recomendaciones Técnicas para el Desarrollo de la Atención Temprana. [Technical Recommendations for the Development of Early Intervention]. Real Patronato sobre Discapacidad. Retrieved from http://bit.ly/2Wpncc9, 2005.
  3. Caurcel, M.J. La Atención Temprana de los trastornos del desarrollo. [Early intervention in developmental disorders] In M.D. López y M.T. Polo (Coords.), Trastornos del desarrollo infantil. pp.27-45. Madrid, Spain: Pirámide, 2015
  4. Espe-Sherwindt M. Family-centred practice: collaboration, competency and evidence. Support for Learning. 2008, 3,136–43. https://doi.org/10.1111/j.1467-9604.2008.00384.x
  5. Fernández Valero R, Serrano AM, McWilliam RA, Cañadas M. Relación entre empoderamiento familiar y calidad de los servicios de atención temprana [Relationship between family empowerment and quality of early childhood care services]. R Est Inv Psico y Educ. 2017, Extra 11;317–21. https://doi.org/10.17979/reipe.2017.0.11.3054
  6. Gútiez, P. (2010). Early Childhood Intervention in Spain: Standard needs and changes. International Journal of Early Childhood Special Education (INT-JECSE), 2010, 2(2), 136-148. Retrieved from http://bit.ly/2XL5wJm
  7. Rahimah, R. & Koto, I. “Implications of Parenting Patterns in the Development of Early Childhood Social Attitudes”, IJRS: Internasional Journal Reglement Society 2022, 3, No.2, 129-133 https://doi.org/10.55357/ijrs.v3i2.226
  8. Martínez-Rico, G.; Simón, C.; Cañadas, M.; Mcwilliam, R. Support Networks and Family Empowerment in Early Intervention. Int. J. Environ. Res. Public Health 2022, 19, 2001. https://doi.org/10.3390/ijerph19042001
  9. Holzinger, D.; Hofer, J.; Dall, M.; Fellinger, J. Multidimensional Family-Centred Early Intervention in Children with Hearing Loss: A Conceptual Model. J. Clin. Med. 2022, 11, 1548. https://doi.org/10.3390/jcm11061548
  10. Liu, S.; Reynolds, B.L.; Ha, X.V.; Ding, C. Professionals as Collaborative Mentors in Early Childhood Family Education. Sustainability 2021, 13, 10644. https://doi.org/10.3390/su131910644
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