Keys to successful early intervention
How do we balanace natural learning with intervention activities?
Buckley SJ. Keys to successful early intervention. Down Syndrome News and Update. 2003;3(3);73-73.
In most countries, it is accepted that children with
learning or intellectual disabilities will benefit from early intervention and
that is the theme of our first two articles. Early intervention programmes began
in the 1970s when research indicated that both children and adults with learning
disabilities need structured teaching and practice in order to help them to
learn skills and activities that typically developing children acquire in their
early years without explicit teaching – mainly all the skills that typical five
year olds have when they start school such as walking, feeding, dressing, talking,
socialising and managing their behaviour.
Smaller steps, more practice
The research indicated that we needed to break these
skills into small steps and to find ways to teach them, building in much successful
practice to help children achieve them. All children need practice to consolidate
and improve their learning and they seem to do this naturally, as parents of
toddlers know when they see them practise new skills such as standing or walking.
Research with children with Down syndrome indicates that they need more repetition
and practice to consolidate their learning and reach their 'personal best' in
any skill. They may need much patient encouragement to practise enough through
individual sessions and family or group games.
Ensuring success – errorless learning
The early research also supported the view that we
need to scaffold children's learning by showing them how to succeed – modelling
an activity with the child by holding their hand to help them complete the task
or to learn by imitating as we take turns at the task with them. In this way,
they practise the correct sequence of actions to succeed at the task.
The benefits of groups
Many children and families benefit greatly from services
such as Portage home teaching programmes, which provide a home teacher for the
family in their own home in the first 3 years of life. This service is usually
highly valued by parents and they learn how to extend their natural play and
interaction with their child in order to help the child to overcome some of
the effects of his or her disability and learn more effectively. However, one-to-one
teaching can become quite demanding for children, as they are always under the
spotlight and expected to 'perform' the task.
Groups can make the learning more fun as the children
take turns, and children who already know the task can model the correct responses
for others who are still learning. In the groups, children are also beginning
preparation for preschool and school, where they need to be able to learn without
one-to-one support and to take turns – sitting quietly while others have their
turn. Families can also turn teaching activities into games by involving other
adults or children in the family – this often persuades a reluctant learner
that he or she would like to join in!
However, formal groups can also be quite demanding
as they do require the child to sit, attend and to wait. Many toddlers with
Down syndrome are surprisingly good at this but some do find it difficult and
need to be gently encouraged to stay in the group – this is one reason why the
pace of activities needs to be quite fast – small tasks which can move from
child to child quite quickly.
Most learning takes place naturally
While we think that it is important for parents to
understand what their child with Down syndrome needs to learn, the specific
difficulties that are holding them back and to build in more teaching and practice
to help them to progress, we need to stress that the children are learning during
all their waking hours and it is all family interactions while feeding, bathing,
shopping, walking in the park etc. that provide all the quality learning experiences.
The group activities described in the next article are designed to help parents
to be more effective in their natural communication with their child and to
practise activities for perhaps 15 minutes a day. However, it is the all day/every
day interactions within the family that really help children to learn – attending
'therapy' sessions will help to give ideas and keep up parents' motivation but
parents and therapists need to recognise that children do not learn to talk
from these sessions alone.
Therapy sessions are successful when we transfer
our skills, knowledge and confidence to parents, and they then become more effective
natural communicators and teachers at home.