User:Adeledaniels5/Early childhood intervention

Definition
Early intervention is a system of coordinated services that promotes the child's age-appropriate growth and development and supports families during the critical early years. In the United States, some early intervention services to eligible children and families are federally mandated through the Individuals with Disabilities Education Act. Other early intervention services are available through various national, regional, and state programs such as Crisis Nurseries and Healthy Start/Healthy Families America. Starting with a partnership between parents and professionals at this early stage helps the child, family and community as a whole.

Early intervention services delivered within the context of the family can aid with the below through the services of physical, occupational, and speech therapy. Some examples include:


 * Help prevent child abuse and neglect
 * Mitigate the effects of abuse and neglect
 * Improve parenting skills
 * Strengthen families
 * Improve the child's developmental, social, and educational gains;
 * Reduce the future costs of special education, rehabilitation and health care needs;
 * Reduce feelings of isolation, stress and frustration that families may experience;
 * Help alleviate and reduce behaviors by using positive behavior strategies and interventions; and
 * Help children with disabilities grow up to become successful, independent individuals.
 * Assistance with technological devices, counseling, and family training.

The earlier children at high risk for abuse or neglect and children with disabilities receive assistance, the likelihood for both short term and long term benefits to occur increases. Short-term benefits of early intervention include primary school readiness, increased learning and school performance, better health and nutrition, as well as a safer and more supportive home environment. Long term benefits of early intervention include reduction in instances of crime, drug use and teen pregnancy as children grow into adolescents and young adults.

History
Early childhood intervention came about as a natural progression from special education for children with disabilities (Guralnick, 1997). Many early childhood intervention support services began as research units in universities (for example, Syracuse University in the United States and Macquarie University in Australia) while others were developed out of organizations helping older children.

Early childhood education has roots in legislation reaching as far back as 1966 with the Elementary and Secondary Education Act. The legislation provides federal funding to primary and secondary education. The act emphasizes equal access to education, aiming to shorten the achievement gaps between students by providing federal funding to support schools with children from low income families. A more modern form of this act is the No Child Left Behind Act passed in the early 2000s. Then only a few years after the Elementary and Secondary Education Act, the Handicapped Children’s Early Education Assistance Act of 1968 was passed which established 75 to 100 programs to support preschool aged children that are disabled.

Further, in 1972 the Economy Opportunity Act of 1964 was amended to extend Head Start programs. Head Start programs started as services to support children from low income families,  the amendment extended the services to support children with disabilities. Head Start programs are the foundation that early childhood intervention was built upon.

In 1975, the Individuals with Disabilities Education Act (previously known as the Education for all Handicapped Children Act) was passed. This was landmark legislation that guaranteed free, appropriate, public, education to all students regardless of ability. IDEA is the legislation that guarantees early childhood education programs to children and families.

In the 1990s, many states in the US put into place a program where the child's pediatrician can recommend a child for early childhood intervention screening. These services are usually provided free of charge through the local school district or county, depending on the state.

Individuals with Disabilities Education Improvement Act (IDEA) Part C
The Part C (originally Part H) program mandates a statewide, comprehensive, multidisciplinary service system to address the needs of infants and toddlers who are experiencing developmental delays or a diagnosed physical or mental condition with a high probability of an associated developmental disability in one or more of the following areas: cognitive development, physical development, language and speech development, psychosocial development, and self-help skills. In addition, states may opt to define and serve at-risk children. The therapies provided by IDEA can be found in the home, child care, early head start, and community settings such as the county. (American Physical Therapy Association) Commonly cited factors that may put an infant or toddler at risk of developmental delay include low birth weight, respiratory distress as a newborn, lack of oxygen, brain hemorrhage, infection, and prenatal exposure to toxins through maternal substance abuse. Other factors, not commonly cited but often experienced are language delays due to factors such as deafness, Autism, learning disabilities, or severe psychosocial issues (ie severe neglect).

Every state now implements Part C fully. The original legislation provided a five-year phase-in period for states to develop their comprehensive system of service for the affected population. Although IDEA does not mandate states' participation in Part H/C, powerful financial incentives from the federal government have led every state to participate. States were provided extensions of the 5-year period as they struggled with the logistic, interagency, and financial demands of developing a statewide system. To ensure a coordinated approach to service delivery and financing of services, federal regulations of Part C require that states develop interagency agreements that define the financial responsibility of each agency and impanel a state interagency coordinating council to assist the lead agency in implementing the statewide system. Regulations also prohibit the substitution of funds and reduction of benefits once the plan is implemented in each state (United States Department of Education, 1993). As states and federal territories (for example, Guam, Puerto Rico, the Virgin Islands) began to plan for implementation of P.L. 99-457 and later IDEA, their first obligation was to designate an agency that would provide leadership in the planning and administration of the state's comprehensive system. In 1989, 22 states or territories had the department of education as lead agency, 11 others had the department of health, another 9 had the department of human services, and the remaining states had combined departments or departments of mental health or developmental disabilities (Trohanis, 1989).

Early Hearing Detection Intervention (EHDI)
The Early Hearing Detection Intervention (EHDI) mandates each state and territory in the United State to implement programs providing newborn screening, diagnostic and early intervention. Programs are publicly funded and provided for free or at reduced cost for any eligible child. This serves all children with hearing loss. Screening occurs prior to hospital discharge. If an infant does not pass the newborn screening will receive diagnostic evaluation before three months of age. They will be enrolled in early intervention if hearing loss is diagnosed.

Early intervention services are designed to support babies and young children with developmental delays and disabilities or at risk for a developmental delay. This includes their families and caregivers. A child under the age of three may be eligible for early intervention services if the child is diagnosed with a medical condition, not reaching age-appropriate milestones, or at risk for a developmental delay due to medical or social history. Depending on the child's needs services may include speech therapy, physical therapy, and other types of services. Each child will receive an Individualized Family Service Plan, covered by IDEA.

History
The EDHI program has developed in efficiency over the past few decades. The Center for Disease Control (CDC) initially began mandating EDHI programs in each state in 2000, when the first funds were authorized from Congress to support its development. The CDC claimed deaf and hard of hearing (DHH) children to be endanger of potential developmental emergencies and thus it was necessary that they get diagnosed as early after birth as possible. There have been a variety of organizations involved in establishing early diagnosis and intervention treatment, many of which are branches under American Academy of Pediatrics (AAP). After 17 years, EDHI federally mandated through a law passed on October 18, 2017 when President Trump signed the Early Hearing Detection and Intervention (EHDI) Act (PL 115-71). In this act, three main U.S. Department of Health and Human Services (HHS) agencies, the (CDC), Health Resources and Services Administration (HRSA), and the National Institutes of Health (NIH), are required to work together to maintain, build up, and support EDHI programs in all the territories of the US. Progress in diagnostic efficiency after EDHI program implementation from 2000 to 2017 has seen substantial increase. In 2000, only 855 infants were identified as DHH, but as of 2016 the number has increased to over 6,000 infants a year. In 2017, 65.1% of the 6,537 children with detected hearing loss were enrolled in early childhood intervention programs. Though these statistics do not prove all diagnosed children get services, there is still a drastic increase of children who were able to access them between 2000 and 2017.

Parent Access
Once a parent decides that they want their child to be evaluated for early intervention, they can reach out directly to their state's early intervention program. A list of these contacts for each state is available on the CDC website. If their child is over the age of three, the parent can contact their local public elementary school to request for their child to be evaluated for special education preschool.

The cost of early childhood intervention services can range greatly depending on the needs of the child, but it is not uncommon for these services to cost thousands of dollars. Each state offers different programs to help make these costs affordable for parents. These programs take financial information such as income, rent/mortgage payments, household size, and medical expenses to calculate the maximum value that the family is capable of paying. Most programs also offer a way for families to request a reevaluation if they believe the amount is too high. In some instances, families can receive full coverage for their child's early intervention services.