Inclusive and Supportive Education Congress International Special Education Conference Inclusion: Celebrating Diversity? 1st - 4th August 2005. Glasgow, Scotland

home about the conference programme registration accommodation contact

Early Intervention: early way(s) of promoting Inclusion

Dr. Paula Santos and Prof. Gabriela Portugal
Departamento de Ciências da Educação, Universidade de Aveiro, Portugal
psantos@dce.ua.pt and gabip@dce.ua.pt

Introduction

The opportunity of working in an Early Intervention program, in which reflective practices and training have a major value, has been of the most importance for our professional and personal development. It had the power of promoting our comprehension of the powerful role families and communities plays, or should play, in the development and well-being of all citizens, particularly in the lives of disadvantaged children.

Early Intervention (EI) as we understand it, is in Portugal, since 1999, established by law – the Despacho Conjunto nr. 891/99, 19-10, a joint document signed by Health, Education and Social Security State Departments; nevertheless, in Aveiro’s district since 1998 there is a protocol firmed by the local agencies of those three departments, the hospital and the university, in order to formalize an important work that was already carried out by agencies and people all over the district for some years. They are committed to assure the needed resources – human, logistic, material, training and research related -, so the communities can count on an articulated structure composed by the agencies and their professionals already working there, but now in a dynamic and innovative way of understanding and doing things, aiming to promote the living circumstances of 0-3 children at risk of serious developmental delay, and their families; a method in which enabling and empowerment are key words. A method where we aim to build a new discipline, a transdiscipline that will emerge if - and only if - early childhood educators, doctors, nurses, social workers and psychologists, all of them belonging to different community agencies, somehow committed to the need of giving support to young children at risk of serious developmental delay (due to established, biological or environmental factors), interact with each other and with communities, families and children, in a certain way. This is a way where attention, respect, trust on each others’ strengths, perception of relationships as the core of human life, and an ecological and reflective way of understanding, interacting and doing things, are crucial. In this presentation, we intend to present the main concepts that lead our practice, the practice in itself, in the different action levels, the research-action project we are developing for the last three years, and some of the available results.

1. The concepts

By Early Intervention, we mean a family centred process, whose ultimate desired goal is the development and well-being of 0-3 children at risk of developmental delay. Its success depends on the processes lived by the families, in their striving to become capable, empowered and in control of their own life, raising their children, participating in the communities they live in, experiencing feelings of emotional well-being and involvement.

Dunst (1988: 32) defines the intervention as the provision of support (i.e., resources provided by others) by members of a family’s informal and formal social network that either directly or indirectly influences child, parent, and family functioning.

Shonkoff and Measles, cit. Boavida and Borges (2003: 25), say that “EI consists of multidisciplinary services delivered to 0-5 children, in order to promote health and well-being, to strengthen emergent competencies, to minimize developmental delays, to remedy malfunctions, to prevent functional deterioration, and to promote parental adaptative capacities and the family functioning in general.

These goals are accomplished through the deliverance of individualized, educational, developmental and therapeutic services to the children, together with mutually planed support to the families.”

The public Portuguese law for EI we mentioned before, defines EI as a family centred, community-based process, aiming the development and well-being of 0-3 children at risk of serious developmental delay, and establishes as axes the family involvement, the Individualized Family Services Plan (IFSP), and team work (by professionals of Education, Health and Social Security state departments and, eventually, by professionals from local institutions too who will articulate knowledge – theoretical and practical, including the specific knowledge they are building in the context of their interaction with each family they are working with   -, with the know how of their agencies).

In sum, we ask these professionals to work as transdisplinary teams, creating an articulated structure of different agencies, approaching the communities, families and children, in the framework of the core values proposed by Doan-Sampon, Wollenburg and Campbell   (cit. Portugal e Santos, 2003a; 2003b):

• Family centred - It means the intervention is guided by the family. Family guided intervention follows the family’s lead in order to respect not only the child’s development, but also the family’s definition and perception of important developmental issues;
• Relationships’ focalized - Parent-child interactions are the heart of EI. Parents and children may experience difficulties in relationships. The challenge in such circumstances is to find and nurture the interactive patterns that are adequate and satisfying and then attempt to facilitate an increase in their occurrence, so they can compete with and replace less satisfying transactions. A trusting relationship between EI professionals and the family is also crucial;
• Based on strengths - The EI process is not intended to intrude upon or judge the family’s patterns of interaction. The role of the professional is to join with the family in finding capabilities and interactive strengths, provide needed information and support the family’s efforts to optimize their child’s developmental outcomes and their individual competence in their parenting role;
• Ecological - EI addresses the broader context of family and community, considering that the different ecological levels interact and influence each other and cannot be treated in isolation. Family culture and environment influence the selection of goals for intervention and the means for reaching the goals;
• Reflective - Recognition of the complex system of variables intervening in EI means that the interventionist must gather information over time about the child, the interactions within the family and the environment. Ongoing communication and reflection insures the flexibility and fluidity of intervention, as new information is incorporated into the family’s plan, according to the changing priorities and perceptions of the family.

Our proposal, the idea that has been leading our training and research efforts for the last years, is to establish a transversality between this EI framework and the Experiential Education model (EXE) (Laevers and Van Sanden, 1997; Laevers, 2000; Laevers, 2003). EXE appears as a framework that offers a more respectful way of feeling, thinking and doing things in Early Childhood Education (ECE) – a “child centred” way, where the adult pursuits, as point of reference, the child’s experience, reconstructing, through his/her expression, word, gesture..., his/her meanings, basing the intervention on child initiative (autonomy), an enriched environment (stimulation) and developing an experiential dialogue (sensitivity), promoting emotional well-being and involvement of the child, and having as ultimate goal the child’s emancipation – i.e., the optimization of the child’s capacities, whatever they are.

We believe that the EXE core concepts highlight EI core concepts and can be seen as completing each other. Let us now analyse a table where we put in parallel the core professional dimensions in the ECE and in the EI Professional styles:

Table 1 – Core professional dimensions in Early Childhood Educator and in Early Intervention Professional Styles.

Thereby, se nsitivity, stimulation and autonomy are crucial dimensions when the aims are involving, respecting and collaborating with families across all the phases of the program.

2. An ecological intervention process

In the context of individual interactions with families, in their natural environments, professionals are supposed to support families (of 0-3 children at risk) in the processes of:

• Identifying needs, expectations, even dreams, related to their well-being, to their mental health, in order to create the psychological space inherent to the task of raising young children;
• Identifying the needed strengths and resources, internal and/or external (informal and formal), in order to make them available to answer the specific needs of the child and the family;
• Creating strategies, plan actions that, once completed (with success), will result in benefits for the family and, in last instance for the child’s development;
• Implementing the plan;
• Evaluating processes and results, and planning in according to those findings;
• Assessing child’s development in a family centred way – it means the family as the major role, as the professional is expected to support, to share specific knowledge about child development, to help families find the perfect match between their culture, their rituals, their daily routines (these are the little things that make us what we are, and offer us the safe environment we need in order to feel comfortable, to find psychological release, crucial to strengthen ourselves to face the challenges and daily demands of life) and the specific needs of the child at risk.

By establishing a bridge between a child centred ECE practice and a family centred EI practice, we intend to promote professional and personal development, scaffolding reflection and self-evaluation, two main strategies for enabling and empowering professionals in the process of developing a sensitive and stimulating attitude and the capacity to promote autonomy of families. These connect with an ecological and person centred model, a reflective attitude, based on strengths and focussing on relationships.

3. An evolving transdisciplinary interagency structure

In the district of Aveiro, we can count on an interdisciplinary and interagency structure, composed by 115 EI professionals (early childhood educators, doctors, nurses, psychologists and social workers) who, in twelve local teams, give support to 170 families/children at risk of serious developmental delay. We must underline that these professionals dedicate only a small part of their weekly schedule to the field of EI (except for a supervisor who does EI supervision full-time). All of them belong to different agencies in the communities/counties, and one of the roles they are asked to play as part of their regular work is the one of an EI professional. Their job is to assure the implementation of the ecological process intervention described before.

Coordinating the local teams, there is a district coordinating team composed by six persons, the presenters of Health, Education and Social Security State Departments, the Hospital and the University of Aveiro. This is the group where the authors of this article intervene; their responsibility is to promote training, supervision, research/evaluation, and to ameliorate circumstances in order to facilitate the local teams’ job. They must elaborate reports in order to document the progress of EI in the field, so state departments can regulate their action and politics according to what’s going on.

In the organization chart 1, we present the structure, from the national to the local levels:

Organization chart 1 – Portuguese Early Intervention (EI) Structure (Despacho Conjunto nr. 891/99 and Aveiro’s protocol for EI).

Organization chart 1

Despacho Conjunto nr. 891/99

Hospital Inf. D. Pedro

We would like to underline the articulation, at all levels, of the Education, Social security and Health State Departments, as well as the presence and the involvement of the Hospital and the University (UA) at the Aveiro’s district level.

The university, in particular, has the responsibility for promoting training and research/evaluation of processes and results. In this context, we’re now developing an action-research project (which will lead to a PhD thesis). It consists of creating the means and strategies to promote quality in the Aveiro’s EI structure. In this regard, some of the most important issues are:

Promoting training with national and international authors – initial, in service, seminars, conferences, conferences and the National Congress of EI (in collaboration with the EI National Association, and the Universities of Minho and Oporto);

The formulation of an EI model where the EI core concepts transverse the Early Childhood Education (ECE)/Experiential Education (EXE) (Laevers, 1997, 2000, 2003) core concepts we advocate in the ECE License in the university, as we’ve stated before;

The creation of the “Self-Evaluation Parameters” for EI professionals/teams and supervisors. In the last two years, we have asked the professionals to reflect on and evaluate their individual and team performance, in the framework of the transversal model referred before - the five EI core values (family centred, relationship focused, strengths based, ecological and reflective) transversing the ECE/EXE core values. It’s a twenty four pages document, comprehending the different interfaces of the work the professionals develop. It’s composed by explanation contents and a self-evaluation scale where people are asked to reflect and place themselves in a 1to 5 performing continuum in each dimension of their professional profile;

The creation of the “Functioning Orientations”, a kind of an “Internal Set of Rules” which is, at once, a normative instrument, aiming at regulating the action in the field of EI, and one more opportunity to inform and train the readers/professionals and teams;

The organization and direction of work meetings with all the district and local agencies’ headquarters involved in EI, affirming the concepts and practices we defend, establishing the different roles of the people and agencies involved at the different levels, offering our actions and contributions, asking for cooperation;

The organization and direction of 3 work meetings per year with the twelve local teams (at about 115 people); we intend to promote cohesion and the building of the new transdisciplinary discipline and profession, the Early Intervention;

The creation of the dynamics manager role, which aims at having someone from the inside of the local team responsible for the accomplishment of the team’s “functioning tasks”, and the organization and direction of work meetings with all of them every two months;

The creation of the supervision structure in Aveiro, and the efforts taken to promote the supervisory quality, supporting the supervisors through work meetings each two weeks, and other training opportunities. The “EI supervision competencies profile” is right now our jewel, the epicentre of our efforts: we believe that, in a family centred Early Intervention system, a parallel process of empowerment and enabling will emerge trough the different levels/actors: an enabled and empowered supervisor will concur to enable and empower EI professionals who, in their turn, will promote circumstances that will foster enabling and empowerment/emancipation of the families and communities, who finally will be more competent in the task of raising and nurturing their children at risk… One can visualize this idea in the following scheme:

Diagram 1 – The parallel process of empowerment and enabling in Early Intervention
A constant in our work is to support, in the communities, the development of dynamics of attention, respect and confidence in all their citizens, believing that is from diversity that comes the enrichment of us all. And that means, as Marsha Forest and Jack Pearpoint (1997) say, that there’s no “them and us”; it’s all “us”.

We think it is worthile to deepen a bit further the theme EI Supervision and EI Supervision Competencies Profile:

4. Supporting early intervention through reflective practice

In the world of professional practice with young children and their families, supervision provides regular opportunities for professionals, both less experienced and more experienced, to reflect together about their professionals situations. Just as families need support, information, attention and respect in order to become confident and more competent, professionals need supportive relationships taking the form of supervision, in order to become empowered and capable. As Fenichel (1999) highlights, an effective supervision includes some essential features: reflection, collaboration and regularity.

“Reflection can be thought of as both the means and the end of the process of supervision. Reflection involves stepping back from the immediate, intense experience of hands-on work… The supervisor offers an enlarged perspective, another pair of eyes, a mirror… Part of the process of developing a professional identity involves recognizing the need to enlarge one’s own knowledge, skills, and sensitivity” (p.13).

Reflecting on professional identity involves examining experienced feelings, values and personal theories; in sum, the continuing conceptualisation of what one is observing and doing.

Working in a wide range of settings and facing intellectual and emotional challenges can be very troubling. Here, the experience of supervision has been described as “having a friend on a difficult journey” (p.14). This is the main reason why an enduring collaborative supervision relationship, nurturing and rewarding, is a desirable part of any training or work environment (only a few want to travel alone through unknown or obscure territory).

Obviously, the development of a supervisory relationship with the characteristics described above needs regularity (time to reflect, time to collaborate and above all, time to establish a trusting relationship).

Different strategies can be implemented in the context of a supervisory relationship. We select case studies and group discussions (Shulman, 1999), and self evaluation.

Case studies and group discussions

One can learn a lot from practice. Stories, critical incidents, cases are important to narrow the space between theory and practice. In order to support supervisees, supervisors need to know their stories, their perspectives and realities. The discussion of cases in the context of supervision and group meetings permits the stimulation of collaborative analysis; the exploration of complex and messy problems for which explicit theories and simple answers do not exist; the generation and examination of different points of view; the development of problem-solving skills; the development of collegiality and a shared understanding in a community of learners; the stimulation of collaborative reflection and strategic introspection of one’s own practice (self-evaluation).

Self-evaluation

One common characteristic of teachers and others social professionals is their difficulty on questioning their practice. Frequently problems are explained by referring to characteristics of children, families, culture, mentalities, school organisation, external programs, government etc., not to the practitioners or professional behaviours. Undoubtedly, they work the best they can and know. In spite of this, it is important to develop a culture of reflection and self-evaluation, of modesty and humility. Students and practitioners must realise the impact of their actions and verbalisations on children and families and understand that if children or families are eventually “difficult ones”, disturbing, uninterested, not motivated, the teacher or professional has to deal with that as his/hers problem, permanently trying out new approaches and alternatives, respecting and trusting children and families. It’s not an external problem, beyond his own control, a problem inherent to the child, family or community, having nothing to do with the professional. There’s always something that can be done.   Constantly, professionals have to question their performance, considering their characteristics, their style etc.

Building an EI Supervision Competencies Profile

Considering the lack of literature in Portugal about EI Supervision and about how to supervise EI professionals, we decided to work on building an EI Supervision Competencies Profile. Our goal is dual: to obtain an instrument that will lead and support the supervisors on their difficult job, and to create opportunities for training, as they are asked to participate in this building process. So, in the framework of “grounded Theory (Strauss & Corbin, 1998), we designed (this part of) our study: we asked the supervisors to be interviewed about EI supervision: what the term meant for them, what is their practice, what would they like it to do, what golden rules do they elect for this field of intervention. Then, after having transcribed all the interviews, we have proceeded to categorizing the statements, looking for common points that would permit the extraction of meaningful and fecund identified properties for EI Supervision, which, in their turn, would eventually lead us through the process of discovering the needed competencies when the aim is to supervise others in EI field. When this process (categorizing the interviews) was over, we asked the supervisors/interviewed to validate it; we are still in this stage. Following the scientific knowledge thinking, we would like to present some emergent categories we found in the interviews, some of the statements that nurtured them, and the competencies we believe are emerging from each of them.

Table 2 - Scientific knowledge thinking scheme.

Tables 3, 4, 5 and 6 – Examples of statements, emergent categories and derived competencies.

Table 3

Table 4

Table 6

In supervisors words, we can point out some g olden rules for EI Supervision:

• Mix knowledge with emotions, involvement and distance, and with clairvoyance, mix wisely, and… serve it to EI professionals, so they can take and bring it when they go to the families!

• Contaminate supervisees with your love and your vision about EI. Leave your own mark!
• Search the goal of maximizing every EI professional’s competences, so he/she is able to bring the families, the best. Then, you can become smaller, disappear or vanish, embrace another task…

6. Concluding…

In the context of our intervention, in the twelve counties of the Aveiro’s district referred before, we feel a growing clarification of roles, and a stronger synergy in the system, which results in higher levels of well-being in the groups and in the individuals, being clearly observed better performances in the direct work with children/families.

In a broader context, we are convinced that the basis for implementing principles and practices recommended in the current literature are established in Portugal. Yet, is our conviction that an internal changing process as the one inherent to EI, demands accompanying, supervising and ongoing reflection processes (this assumption applies to all actors: professionals, families and communities), that we effort at once, to play and to promote.

Knowing that there are, currently, several Portuguese institutions interested in and investing in professional training and research in EI field, at the level of the degree’s curricula, master degrees and PhD’s, we think we can expect an increasingly better quality in the interventions being held in the field, having as ultimate result higher levels of well-being and development of professionals, families, children and communities.

In the other end, the joint law nr. 891/99, as result of several movements already going on in some regions of the country, as generated synergies, implemented dynamics that, although demanding nurture (accompanying, supervision, which are not always easy to get, when human resources are the central need), we believe are irreversible. In fact, by the last four years, we have noticed a positive changing at the level of the inter-agencies articulation, the social support networks getting stronger; there have been changes in the ways of functioning, in time and resources management. Compromises have been assumed with the formal and informal members of the communities – it is the case of the Commissions for Protecting at Risk Children and Youth (work groups leaded by the Minister of Justice/Law, but organized in an interministerial model, too), Health Centres and Hospitals (Health State Department), Schools, Institutions granted by Social Security State Department, Multiprofessional Teams (other work groups organized in an interministerial model, aiming at the diagnostic and referral of children with special educational needs). Thereby, EI’s inclusion in educational, social and health policies in Portugal seems inevitable.

Nevertheless, we consider as maybe our most important aspiration, to establish mechanisms that will assure the continuity of EI as a force for promoting quality in the lives of the families and children at risk of developmental delay, independently (or at least as autonomous as it can be) of the momentaneous policies, or the specific individuals assigned to work on the different coordinating structures. In sum, it’s our desire that the communities will appropriate the dynamics we present, so they become, in fact, valuable instruments to promoting their well-being and development.

References:

Boavida, J. & Borges, L. (2003). Intervenção Precoce em Desenvolvimento. Saúde Infantil 2003 25/3: 23-34.

Dunst, C., Trivette, C & Deal, A. (1988). Enabling and Empowering Families: Principles and Guidelines for Practice. Cambridge, MA: Brookline Books.

Fenichel, E. (1999). Learning through Supervision and Mentoring To Support the Development of Infants, Toddlers and Their Families: a source book. Washington D.C.: Zero to three/National Centre for Infants, Toddlers and Families.

Forest, M. and Pearpoint, J. (1997). All my life is a circle. Toronto: Inclusion Press.

Laevers, F. & Van Sanden, P. (1997). Pour une approche expérientielle au niveau préscolaire. Livre de base . Col. Education et Enseignement Expérientiel, nº1. Centre pour un Enseignement Expérientiel, Louvain.

Laevers, F. (2000). Forward to basics! Deep-level learning and the experiential approach. Early Years, vol.20(2), 20-29.

Laevers, F. (2003). Experiential Education: making care and education more effective through well-being and involvement. In Ferre Laevers &Ludo Heylen (eds.), Involvement of Children and Teacher Style: insights from an international study on experiential education. Studia Pedagogica 35. Leuven: Leuven University Press. 13-24.

Portugal, G. & Santos, P. (2003a). A Abordagem Experiencial em Intervenção Precoce: na formação, supervisão e intervenção. Psicologia, Vol. 17 , nº 1, pp. 161-177.

Portugal, G. & Santos, P. (2003b). Enabling and empowering Early Intervention Professionals – a reflective practice based on Experiential Education. In Laevers, L. & HEYLEN, L. (eds.). Involvement of Children and Teacher Style. Leuven: Leuven University Press, pp. 129-142.

Portugal, G. (2002). Dos primeiros anos à entrada para a escola – Transições e continuidades nas fundações emocionais da maturidade escolar. Aprender , nº 26, Setembro 2002.

Shulman (1999). Oral Conference in the University of Aveiro. Notes taken by the authors, not published.

Strauss, A. & Corbin, J. (1998). Basics of Qualitative Research. Techniques and procedures for developing Grounded Theory. Thousand Oaks (EUA): Sage Publications.

home . about the conference . programme . registration . accommodation . contact