Unit 4: Early Identification and Intervention:

4.1 Concept, need, importance and domains of early

identification and intervention of disabilities and twice
exceptional children;
4.2 Organising Cross Disability Early Intervention services;
4.3 Screening and assessments of disabilities and twice
exceptional children;
4.4 Role of parents, community, ECEC and other stakeholders
in early intervention as per RPD- 2016 and NEP 2020;
4.5 Models of early intervention-(home-based, centre-
based, hospital-based, combination) with reference to
transition from home to school;
4.1 Concept, need, importance and domains of early identification
and intervention of disabilities and twice exceptional children
Early Identification refers to a parent, educator, health professional, or other
adult
The earliest years of a child's life are critical. These years determine child's
survival and thriving in life, and lay the foundations for her/ his learning and
holistic development. It is during the early years that children develop the
cognitive, physical, social and emotional skills that they need to succeed in life.
The World Health Organization (WHO) states that early childhood is the most
important phase for overall development. Factors like disability and malnutrition
pose particularly difficult challenges. However, if these problems are solved at an
early age, it minimizes developmental risks and enhances child development.
However as per guidelines of IDEA (Individuals with establishing the socio-
demographic profiles & the Disabilities Education Act) of United States, "Early
pattern of clinical features in children attending EIP. The intervention services are
designed to meet the study also sought to assess the profile and expectations of
developmental needs of children, from birth to three years people who attended
the clinic with the long term of age, who have a delay in physical, cognitive,
objective of modifying the program as per their needs. communicative, social,
emotional or adaptive development or have a diagnosed condition that has a high
probability of resulting in developmental delay"Individuals with (Disabilities
EducationAct, 2001.
If children with developmental delays or disabilities and their families are not
provided with timely and appropriate early intervention, support and protection,
their difficulties can become more severe often leading to lifetime consequences,
increased poverty and profound exclusion. Typical development is sometimes a
struggle. Everyone likes to think that all babies will be okay, that parents will have
nothing to worry about. But the reality is that not all babies will keep up, and
some will continue to fall further and further behind. Science demonstrates that
intellectual and cognitive potential is determined by how the brain develops
during the first few years of life. The brain controls the biological effects of all the
other organ systems and influences cognition, intelligence, learning, coping and
adaptive skills, and behaviour. Because the brain controls these different aspects
of human life, impaired brain function leads to impaired physical, mental, and
emotional health and decreased functioning in society. Therefore, investments in
early childhood to support healthy brain development help to reduce societal
costs in remediation, health care, mental health services, and increased rates of
incarceration.
There are a number of reasons for this early identification:

Early Identification leads to early intervention, which is considered essential in

remediation.
The children have not yet faced academic failure therefore it becomes easier
to work with them as they still retain their motivation to learn.
At that young an age they have not developed the compensatory strategies,
which will later form barriers in the remedial process.
Research has shown that children who received assessment and remedial
services at a younger age were better able to cope with the disability and
had a better prognosis than those who received help later.

To determine eligibility for early intervention, a child will either receive a

qualifying diagnosis (such as autism) or greater delay in one or more of the five
domains of development. These include: physical, cognitive, communicative,
socioemotional, and adaptive. Let

Physical
This domain involves the senses (taste, touch, sight, smell, hearing, and
proprioception

Humans develop physical ability directionally, from top to bottom and the
center outward. A baby will at first have the ability to turn the head and sit
upright, before being able to reach, grab, and eventually walk and run as they
progress into toddlerhood (2-3 years). All the while child should be able to
instinctively respond and react to stimuli in his or her physical environment.
Cognitive
The cognitive domain of development refers to the ability to mentally process
information
1. During the sensorimotor stage of cognitive development (0-2 years),
humans are essentially limited to perceiving the world on a purely
sensory level. And adult makes a funny face at you? Laugh at what you
see. Dangles a toy in front of you? Reach for it.
2. By the time a child reaches the preoperational stage (2-6 years), he or
she is beginning to incorporate language into his or her analysis of
people and surroundings. However, in most cases, logical functioning isn
3. Prior to hitting puberty, a child should have arrived in the concrete
operational stage (7-11 years), where he or she can process events and
information at face value, but will still generally not be able to
accommodate abstracts or hypotheticals.
4. Persons 12 years and up are said to be in the formal operational stage,
able to perform the intricate mental gymnastics that make human
beings so remarkable. Thinking in the abstract
Communicative
The ability to comprehend, utilize, and manipulate language may be the
single most powerful skill a person can develop. The four aspects of
language development are phonology (forming a languagetelegraphic
speech, simple sentences communicating the essence of a want or need.

Socioemotional
To truly thrive, we must learn to exist peacefully within ourselves and
coexist with others. As a child develops within the socioemotional
dimension, he or she learns how to successfully regulate his or her own
internal emotional state and read the social cues of others. Strong
emotions can be controlled or expressed properly; confrontation can be
managed without violence; we can evolve empathy toward others.
By 6 months, a baby should be reacting to facial expressions and
reciprocating.
By a year, clear preferences in terms of likes and dislikes should begin to
surface
By two years, a child should be engaging in parallel play with his or her
peers. Each child may be involved in a separate activity, but they are
interested in each other
By three years, the awareness of self should have begun to form, and an
ability to express feelings.
By four years, the child should be able to cooperate with others, abide
by simple rules, and manage emotions without tantrums or
aggression.
Adaptive
 Adaptive development refers to the self-care component of growing up,
taking care of things like eating, drinking, toileting, bathing and getting
dressed independently. It also entails being aware of one

An intervention is a deliberate process by which change is introduced into

peoples' thoughts, feelings and behaviors.

Purpose of Intervention

Identifying curriculum & Instructional practices.

Developing new, or modifying existing preschool curricula

appropriate teacher professional development.

Establishing the efficacy of existing preschool curricula

Developing and validating early assessment tools

Early Intervention (EI): Supporting infants and toddlers

At some point almost all early educators work with a child who receives or needs
early intervention (EI) services. Early intervention consists of services and
supports designed to help children who have a developmental delay or special
need, and their families. Through collaboration with families and related service
providers, supportive practices for infants and toddlers who receive EI services
can be implemented within existing routines and across environments.

Early intervention is a resource that increases the likelihood of long-term success

as children transition into formal schooling and eventually move into the work
force.

Early Intervention

The introduction of planned program deliberately timed and arranged in-order to

alter the anticipated or projected course of development. [Siegal -1972].

Preventive
Curative
 Remedial
Alternative methods

Early intervention can sometimes help a child catch up to peers There are
three primary reasons for intervening early with an exceptional child:

1. to enhance the child's development,

2. to provide support and assistance to the family, and

3. to maximize the child's and family's benefit to society.

Effectiveness of Early Intervention

needing fewer special education and other facilitative services later in life;

being retained in grade less often; and

in some cases being indistinguishable from non handicapped classmates years

after intervention.

Focus of Early Intervention

Screening

Identification

Prevention of disability or delay

Promotion of positive assets of a developmentally delayed child

Enhance the capacity of the family to meet the special needs of their infants
and toddlers

The IFSP as a guiding tool: Progress-driven vs outcome-focused

An Individualized Family Service Plan (IFSP) is a document that accompanies a
child with developmental delays/special needs from birth until the age of three. It
summarizes the child
When early care and education (ECE) professionals observe a child using his IFSP
as a guide, it is important for professionals to:

1. Communicate often with the parent/guardian about the whole child

and how she exhibits specific outcomes. For example, she uses key
words or signs such as
2. Keep a running record of observations related to the whole child, not
only to the outcome that he is working on.
3. Utilize the early intervention providers working with the child, ask for
support strategies or adaptations for the individual child and, as
appropriate, with the whole class.
4. Identify the child
5. Do what works for as long as it works. Reassess often to ensure that
supports progress as the child progresses.

Twice-exceptional students (also known as 2e children or students) are among

the most under-identified and underserved population in schools. The reason for
this is two-fold: (1) the vast majority of school districts do not have procedures in
place for identifying twice-exceptional students and (2) inadequate identification
leads to the lack of access to appropriate educational services. Additionally, twice-
exceptional students, whose gifts and disabilities often mask one another, are
difficult to identify. Without appropriate educational programming, twice
exceptional students and their talents go unrealized. In this article, we

What is twice exceptional (2e)?

The term education programs and counseling support.

What are the characteristics of twice exceptional children?

Twice exceptional kids may display strengths in certain areas and weaknesses in
others. Common characteristics of twice exceptional students include:

Outstanding critical thinking and problem-solving skills

Above average sensitivity, causing them to react more intensely to sounds,
tastes, smells, etc.
 Strong sense of curiosity
Low self-esteem due to perfectionism
Poor social skills
Strong ability to concentrate deeply in areas of interest
Difficulties with reading and writing due to cognitive processing deficits
Behavioral problems due to underlying stress, boredom and lack of motivation

4.2 Organising Cross Disability Early Intervention services

4.3 Screening and assessments of disabilities and twice exceptional
children;

Screening
Screening refers to the use of standardized assessment to identify delays in
development that may indicate the need for further evaluation.
Screening is the first step in the assessment process. It is a fast, efficient way to
identify students who may have disabilities and should undergo further testing. It
quickly establishes for the assessor that the student may require the services of a
professional who will then be able to administer the necessary measures to either
diagnose or rule out the presence of a disability. Screening tools are often easy to
administer and classroom teachers can be trained to use these effectively to
collect the initial impressions and information.

Screening of students may result in either the conclusion that there may be no
requirement of further investigation but adjustment of teaching or it may lead to
a referral for further, more comprehensive assessment.
Though often they are a part of the same process it is important to distinguish
between screening, evaluation and assessment.

It is usually these teachers who do the screening through their informal measures
including classroom tests. They are the ones that observe the students over a
period time and can talk of a pattern of behavior, which is so important in the
assessment process. Therefore it is appropriate to say that the assessment
procedure requires input form both informal measures adopted by teachers for
screening and tracking the progress of the student and the formal tests that firmly
establish the diagnose and provide the standards for comparison.

Referral

Referral is the initial request to consider a student for a special education

evaluation.

It is usual for classroom teachers or parents to make the initial request. This is a
follow up of observations over a period of time and collection of initial
impressions about the student
 Assessments of disabilities

"To assess" derives from the Latin verb "Assidere", to sit by (originally, as an
assistant-judge in the context of taxes). Hence, in "assessment of learning" we "sit
with the learner

In education, the term assessment refers to the wide variety of methods or tools
that educators use to evaluate, measure, and document the academic readiness,
learning progress, skill acquisition, or educational needs of students.

Definition

" Assessment is the process of gathering and discussing information from

multiple and diverse sources in order to develop a deep understanding of what
students know, understand, and can do with their knowledge as a result of their
educational experiences; the process culminates when assessment results are
used to improve subsequent learning."

(Huba, M. E. and Freed, J. E. (2000).

Major forms of Educational Assessment and Purposes

1. High-stakes assessments are typically standardized tests used for the
purposes of accountability
2. Pre-assessments are administered before students begin a lesson, unit,
course, or academic program. Students are not necessarily expected to know
most, or even any, of the material evaluated by pre-assessments
3. Formative assessments are in-process evaluations of student learning that
are typically administered multiple times during a unit, course, or academic
program. The general purpose of formative assessment is to give educators in-
process feedback about what students are learning or not learning so that
instructional approaches, teaching materials, and academic support can be
modified accordingly. Formative assessments are usually not scored or graded,
and they may take a variety of forms, from more formal quizzes and
assignments to informal questioning techniques and in-class discussions with
students.
4. Summative assessments are used to evaluate student learning at the
conclusion of a specific instructional periodfor learning because educators use
the results to modify and improve teaching techniques during an instructional
period, while summative assessments are said to be of learning because they
evaluate academic achievement at the conclusion of an instructional period.
Or as assessment expert Paul Black put it,
5. Interim assessments are used to evaluate where students are in their learning
progress and determine whether they are on track to performing well on
future assessments, such as standardized tests, end-of-course exams, and
other forms of assessments, which are integrated into the instructional
process).
6. Placement assessments are used to
7. Screening assessments are used to determine whether students may need
specialized assistance or services, or whether they are ready to begin a course,
grade level, or academic program. Screening assessments may take a wide
variety of forms in educational settings, and they may be developmental,
physical, cognitive, or academic. A preschool screening test, for example, may
be used to determine whether a young child is physically, emotionally, socially,
and intellectually ready to begin preschool, while other screening tests may be
used to evaluate health, potential learning disabilities, and other student
attributes.
Assessments are also designed in a variety of ways for different purposes:
8. Standardized assessments are designed, administered, and scored in a
standard, or consistent, manner. They often use a multiple-choice format,
though some include open-ended, short-answer questions. Historically,
standardized tests featured rows of ovals that students filled in with a number-
two pencil, but increasingly the tests are computer-based. Standardized tests
can be administered to large student populations of the same age or grade
level in a state, region, or country, and results can be compared across
individuals and groups of students.
9. Standards-referenced or standards-based assessments are designed to
measure how well students have mastered the specific knowledge and skills
described in local, state, or national learning standards. Standardized tests
and high-stakes tests may or may not be based on specific learning standards,
and individual schools and teachers may develop their own standards-
referenced or standards-based assessments.
10. Common assessments are used in a school or district to ensure that all
teachers are evaluating student performance in a more consistent, reliable,
and effective manner. Common assessments are used to encourage greater
consistency in teaching and assessment among teachers who are responsible
for teaching the same content, e.g. within a grade level, department,
or content area. They allow educators to compare performance results across
multiple classrooms, courses, schools, and/or learning experiences (which is
not possible when educators teach different material and individually develop
their own distinct assessments). Common assessments share the same format
and are administered in consistent ways assessment, or they use the same
scoring guides to interpret results. Common assessments may be e.
11. Performance assessments typically require students to complete a complex
task, such as a writing assignment, science experiment, speech, presentation,
performance, or long-term project, for example. Educators will often use
collaboratively developed common assessments, scoring guides, rubrics, and
other methods to evaluate whether the work produced by students shows that
they have learned what they were expected to learn. Performance
assessments may also be called
12.Portfolio-based assessments are collections of academic worklearning
standards.

As individuals, each of us has a unique combination of strengths and weaknesses.

But sometimes we are exceptionally strong or weak in certain areas. In the school
setting, students with exceptional strengths and weaknesses may have different
instructional needs than other students. Twice exceptional or 2e is a term used to
describe students who are both intellectually gifted (as determined by an accepted
standardized assessment) and learning disabled, which includes students with
dyslexia.
The NAGC (National Association for Gifted Children) recognizes three types of
students who could be identified as 2e:
Identified gifted students who have a learning disability
Students with a learning disability whose giftedness has not been identified
Unidentified students whose gifts and disabilities may be masked by
average school achievement
How can we identify 2e students?
Parents and teachers may fail to notice both giftedness and dyslexia. Dyslexia may
mask giftedness, and giftedness may mask dyslexia. Some common characteristics
of 2e individuals follow:
Superior oral vocabulary
Advanced ideas and opinions
High levels of creativity and problem- solving ability
Extremely curious, imaginative, and questioning
Discrepant verbal and performance skills
Clear peaks and valleys in cognitive test profile
Wide range of interests not related to school
Specific talent or consuming interest area
 Sophisticated sense of humor
Key points to consider about assessments:
An assessment should be developmentally appropriate. Some tests are
better suited for identifying skills in the very young rather than the older
Developmental change can cause changes in test scores because the types
of variables that tests measure can change with age, and a child
child to test as gifted at age 5 but not test as gifted when tested again at age 7.
This is one reason that a thorough evaluation that includes more than one
aptitude test is very important.
The tests used should validly measure the relevant skills. Some schools have
a
Achievement Tests

Achievement tests determine what the students already have learned and if they
are more advanced than their grade level peers. They may be academic specific
(i.e. Math or Language Arts) or standardized tests (such as SATs, ITBS, SRA, and
MATs). These assessments should not have a ceiling so students are able to show
all of what they know. Tests specifically designed for the gifted population
include Test of Mathematical Abilities for Gifted Students or Screening Assessment
for Gifted Elementary Students (SAGES).

Ability Tests

Intelligence quotient (IQ) or cognitive abilities test scores are also used to identify
gifted and talented students. While these tests provide information for the
intellectual domain, these tests are not as helpful in identifying someone with
creative, leadership, or other abilities. Typical ability tests include:

Individual

Stanford Binet (L-M)

Wescher Intelligence Scale for Children, 4th Edition. Read NAGC's position
papesr Use of the WISC-V in Gifted Education and the WISC-IV.
Woodcock Johnson
 Nonverbal tests, such as the Naglieri Nonverbal Ability Test or the Test of
Nonverbal Intelligence, may be more effective for students from culturally
and linguistically different or low-income backgrounds to eliminate barriers.

Group

CogAT
Otis-Lennon
Hemmon-Nelson
Ravens Progressive Matrices
Matrix Analogies Test

4.4 Role of parents, community, ECEC and other stakeholders in early

intervention as per RPD- 2016 and NEP 2020;
It is observed that though mental illness has been included as a condition of
disability, special needs of persons with mental illness (PMI) and their families
have not been properly addressed. PWD with mental illness require special and
different types of attention and care due to the nature of their illnesses.
Frequently, persons with severe mental illness are not in a position to be aware of
their illness because of the lack of insight. In these circumstances, their families
are great asset in providing them care and support. In our country, where
personnel resources in mental health care are extremely scarce, family is a very
important asset in the management of mental illness. Family members need to be
involved to the greatest extent in the mental healthcare and family support should
be encouraged as it provides moral, emotional, and physical support to the PMI.
However, the provisions of the section 7(2) of the Act may result in a situation, in
which the family members and other caregivers may be less willing to be proactive
and rather be scared to provide the required help.
In this way it can be said that RPwD Act, 2016 is praiseworthy step to ensure the
aim is to provide social justice, equality and opportunity to all persons with
disabilities of India . To fulfill these aims various organizations either government
or non-government play a vital role. So, for the implementation of the act at its
high and progressive level all these agencies should work hand in hand with firm
determination and honesty.

Parental involvement in a child

Parental involvement may be different from culture to culture and society to

society. Parental involvement may have different types, which might have
differential influence on academic performance of their children. Parental
expectations have a greater impact on student

Parental involvement categorized into four broad strands;

Parental involvement in children
Parental involvement in children
Direct parental involvement in academic activities of children and
Indirect parental involvement in academic activities of children.

It is true that parental involvement level vary among parents. For example mother
parent of young children, educated or uneducated parents, father

Parents

Parents increase interaction with their children, become more responsive and
sensitive to their needs and more confident in their parenting skills.
Educators acquire a better understanding of families
Schools, by involving parents and the community, tend to establish better
reputations in the community.

The role of a community towards the disabled individual can be easily elaborated if
we emphasize on creating friendly relationships with pure intent and
understanding. First of all

The common ideology of all these platforms is to provide a sense of belonging for
the disabled individuals where they can share their real life experiences online in a
safe, comforting and friendly environment.

One of the major step towards a collaborative community is to be provided with

trained teachers taking the responsibility of engaging the disabled individuals. The
importance of a trained teacher is substantial in an inclusive education and the
necessity of achieving better results by filling the space for the disabled individual
with knowledge and a sense of recognition. The right training of the teachers
should not be overlooked by the authorities but instead encourage the
trainee/trainers to participate in professional development courses. Hence,
teachers are the pioneers of a community in building a common ground for the
individuals facing any disability. Thus, with their training, the disabled individuals
can succeed and shine in any desired platform.

Special educators

Teachers with a degree in special education are trained to work with children with
special needs. There are even specializations within the field of special education
for specific disabilities like learning disabilities. Special educators are trained to
design IEPs, conduct informal assessments, identify children with disabilities,
design intervention and deliver the remedial programme to the children. Schools
may employ special educators, or they may work privately to help support children
with disabilities.

Role of the Special Education Teacher

 Instruct students in the development of skills and knowledge that enables
them to participate independently to the highest degree possible, based on
assessment needs
 Provide consultation and support services including in-service training to
regular & special education teachers, school personnel, and peers
concerning Adapted Physical Education needs and appropriate methods of
adaptation for the student that will foster maximum independence and
safety
 Works with members of the IEP team (i.e. parents, classroom teachers,
speech providers, occupational & physical therapists, orientation & mobility
and vision specialists) to provide a functional and meaningful program
 Create a program geared to the assessed needs, goal & objectives,
functional levels and motivational levels of the student
  Prepare and utilize equipment and materials for the development of skill as
it is related to Adapted Physical Education (i.e. beeper balls. sponge balls,
batting tees, etc.)
 Conduct assessment which focuses on both long and short-term needs of
the student
Early childhood education
Early Childhood Education or ECE, as it is commonly known, is a stream of
education which relates to the formal and informal teaching of children from
birth up to the age of eight. This particular field of study originated in European
countries and has since gained a lot of popularity. It has now become a norm in
most developed and developing countries. A child
Benefits of early childhood education
In order to provide a child with an environment that is supportive, as well as
nurturing, it is very important that we understand how crucial these early years
are and how we as parents and educators can contribute to making it
intellectually stimulating. The power of early year education is immense with a
plethora of benefits such as better social skills, increased confidence levels,
greater coordination, creativity and increased confidence levels.

4.5 Models of early intervention-(home-based, centre-based,

hospital-based, combination) with reference to transition
from home to school;

In the field of disability, early intervenlion refers to planned and organized efforts
to enhance the development of children, who have a disability or who are at risk
of developing it. Typically, early intervention programmes focus on children from
birth to six years of age.

The aim of early intervention is to provide the child with an environment that
fosters his development in all areas; including language, cognitive (mental),
behavioural, social and emotional. Thus, the objective is to minimize the negative
impact of the impairment or the disabling condition on the overall development of
the child, and the inter-relationships within the family. Early intervention thus
involves:

(i) providing appropriate stimulation to the child with disability and carrying out
individualized educational and therapeutic activities, and

(ii) providing necessary support, guidance, and training to the family.

There are different ways in which early intervention services can be provided. The
services can be direct or indirect. When the services are provided by the
professional or early intervention team member(s) directly to the child, they are
called direct services. When they are provided to the parents or caregivers, who in
turn work with the child, they are called indirect services. The services can be
provided in the home setting, in a centre, or by adopting an approach that
combines the two.

Home-based Intervention

This is a common method of providing intervention - the services are provided to

the chiid and the family members at home. The professional intervener visits the
house of the child with, interacts with the family members, and observes their
routine, practices, cultural and social activities. She/he estimates the available
resources in terms of family members, finances, and materials. This helps the
professional to understand the background of the child with disability and his
family. Also to find out the strengths and needs of the child. If the child needs any
medical help, she helps to arrange for it. Her home visit may have been a referral
from the Primary Healt , Centre, where the child's medical needs are being taken
care of. In such cases, the home intervener helps to ensure follow-up of medical
requirements, such as taking medicines on time. She also guides the family in
getting the child's hearing loss assessed, and in the procurement of appropriate
hearing aids. She evaluates the child to determine what skills and abilities he
already has, and which are the ones that he is ready to acquire.
After understanding the family and its environment, assessing the child, and
ensuring medical intervention (if needed) and the acquisition of suitable hearing
aids, the home trainer focuses on the training aspect. She works with the parents
to prioritize the training needs, and to plan the required training activities.
Further, she demonstrates to the parents and other family members how to carry
out the programme suited to the child's needs.

Having taught the parents how to do the various training activities with the child,
the trainer makes periodic visits to the house in order to monitor the progress of
the child and to help the parents with any problem. These visits could vary from
one to three times a week, depending on the need of the family as well as mutual
convenience. She also maintains a record, in simple form, of her assessment of
the child, his progress, and the present activities being carried out.

Thus in the home-based intervention model, the parents become the child's
primary teachers. This type of programme demands much of I parental time,
dedication and motivation. Therefore, it is important for the home trainer to
identify at least one other person at home, apart from the mother (for example
the grandfather or aunt) who can give training to the child. Ideally, all family
members should be involved and sensitized. Even brothers and sisters can be
trained to give home-based training to the hearing impaired child. The siblings can
be taught play way methods of providing stimulation to the child - they often do it
more effectively than an adult!

Centre-based Intervention

This is a system where the parents take the child to a centre for children with
disability, where training is provided to the child and often, to the parents as well.
At the centre, a group of experts, including a doctor, audiologist, social worker,
special educator, speech therapist, occupational therapist, and so on, attend to
the child and train the parents and other caregivers to carry out tasks at home to
foster the development of the child. These types of services are essential for
children with multiple handicaps, for instance the deaf-blind, or deaf and mentally
challenged, or deaf with cerebral palsy etc.
There are three ways in which the expert team at the centre may interact with -
the parents and the child:

Each member of the expert team meets the parents and the child, and provides
intervention.
The team of experts, collectively, attends to the child and the family and
provides intervention.
All experts meet and discuss the child's case and one team member receives
information and guidance from all of them and in turn interacts with the
child and the family.

Any of these three ways of functioning or a combination can be found at a centre.

Each of these ways of functioning of the professional team at the centre has its
own strengths and limitations.

Combined Model

The combined model is, as the name suggests, a combination of homebased and
centre-based intervention strategies.

Under this model, the parent and the child receive a combination of services. That
is, the child visits the centre periodically, say once a month. During the other days,
the home trainer, who is the link between the centre and the family, visits the child
at home once every 2-3 days and provides services. Thus, the child receives both
kinds of services - home-based and centre-based.

Depending on the location of the centre, residence 01 the child, availability of

resources, practical conven;c.nce, needs of the child and availability of services, a
parent can choose the combined programme - if it is available! This will have the
advantages of both home-based and centre-based programmes.