Early intervention

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The term early intervention is a collective term for educational and therapeutic measures for children who are affected or threatened by a disability . The measures of early intervention include the period of the first year of life and may be up to the kindergarten occurs or until the enrollment extend. This varies depending on the federal state or canton or the organizing disability direction.

General and special early intervention

A distinction is made between general early intervention and special early intervention : While general early intervention is aimed at children with intellectual or cognitive and emotional disabilities and children who are at risk of a corresponding disability without assistance, special early intervention is aimed at children with sensory disabilities such as B. blindness , visual impairment , deafness or hearing loss . If there are general development deficits as well as a sensory impairment, both early intervention offers can work in a complementary and cooperative manner.

General early intervention

The focus is usually on pedagogical - mostly curative - aids, such as development support, e.g. B. provides incentives through appropriate and usually very playful methods. In addition, in many cases there are medical-therapeutic measures such as B. be provided by physiotherapy , occupational therapy , speech therapy or motopedics . If educational and medical-therapeutic services work together, one speaks of a complex service . In Germany, early intervention services are mainly provided in ( interdisciplinary ) early intervention centers , independent curative educational practices and social pediatric centers .

Special early support for children with sensory impairments

Trained special school teachers in the relevant subject work in early intervention for children with a sensory disability . For the successful development of a child, it is of crucial importance to 'go through' all stages of development in an age-appropriate manner. Particularly during the sensitive phases , specific support must be given, as otherwise 'normal' development can be threatened. In terms of content, early supporters of children who are visually impaired or blind are mostly guided by the findings of Lilli Nielsen , who has also developed the relevant learning materials. In addition to promoting the child, parenting is an important focus. Due to the comparatively small number of children with sensory impairments in Germany in contrast to the higher number of children in general early intervention, there are considerably fewer early intervention centers. However, these individual early intervention centers have a large area of ​​responsibility and cover the entire federal territory, so that one can also turn to early intervention centers far away if necessary. Early intervention is largely mobile, which means that the employees employed there (e.g. remedial pedagogues, social pedagogues, special pedagogues) visit the children in their parents' home or in the kindergarten and support the child there and, if necessary, advise the parents . An exception is e.g. B. Hamburg, where outpatient early intervention is carried out in the special school.

In early intervention for children with a hearing impairment, there is an interdisciplinary collaboration with standard kindergartens, hearing aid acousticians, ear, nose and throat specialists, speech therapists and general early interventionists.

Legal situation

Legal entitlements to the financing of early intervention measures are summarized in the Social Security Code, Book XII - Social Assistance ( SGB ​​XII ) and in the Rehabilitation Act (SGB IX, § 30), in health insurance law (SGB V) and for children with mental disabilities in the child and youth welfare law ( SGB VIII / KJHG ). Since - depending on the place of residence - the benefits of early intervention are extremely different, the legislator issued a statutory ordinance in June 2003 - "Ordinance on the early detection and early intervention of disabled and children at risk of disability", also known as the early intervention ordinance (FrühV). This should ensure that medical-therapeutic and curative educational services are more closely interlinked and provided in a more coordinated manner on the basis of financing agreements.

In practice, however, it has been found that the hopes associated with the ordinance have so far only been insufficiently fulfilled. More than two years after the ordinance was issued, a state framework recommendation has only been concluded in North Rhine-Westphalia, which came into force on April 1, 2005. This is an essential step towards specifying the requirements for interdisciplinary early intervention centers and social pediatric centers, and the chances for a comprehensive and targeted further development of the early intervention system have been increased. On this basis, specific local agreements must then be concluded. With the successful approach in North Rhine-Westphalia, a process has now started that has also led to the conclusion of corresponding recommendations in other federal states. For example, with effect from August 1, 2006 in Bavaria there is a corresponding “framework agreement for the early detection and early support of disabled children and those at risk of disability in interdisciplinary early support centers”. In NRW, municipal agreements are about to be concluded in various districts and independent cities (e.g. in Dortmund and the district of Gütersloh). This would be the last important step and help the early intervention complex service achieve a breakthrough. Successful deals should also lead to similar service agreements / contracts being concluded in other municipalities in Germany.

Early intervention in individual federal states

Lower Saxony

In Lower Saxony, special early support is a voluntary service provided by the state. Starting from the locations of the state education centers for people with hearing impairments in Hildesheim , Oldenburg , Osnabrück and Braunschweig as well as the state education center for blind people in Hanover , all of Lower Saxony is covered on a mobile basis.

  • State education centers (for people with sensory impairments) offer advice and early support throughout Lower Saxony. The early intervention period extends from the occurrence of the disability (time of diagnosis) to school entry. They then offer further support during school and vocational training. The State Education Center for the Hearing Impaired has facilities in Hildesheim, Osnabrück, Oldenburg and Braunschweig, the State Education Center for the Blind Hanover (LBZB) in Hanover.
  • General early intervention is offered by Lebenshilfe early intervention centers

In addition, there are so-called early detection centers in Lower Saxony, which are mainly dedicated to diagnosing and drawing up a treatment plan.

North Rhine-Westphalia

In North Rhine-Westphalia there are well over 100 early intervention centers , of which only a small part (approx. 30) work on an interdisciplinary basis. The 30 or so social pediatric centers approved by the relevant committees of the health insurance companies and the associations of statutory health insurance physicians in North Rhine-Westphalia always have an interdisciplinary approach and deal with the diagnosis and treatment of more complex (threatened) disabilities and developmental disorders in children.

Schleswig-Holstein

The majority of the early intervention centers in Schleswig-Holstein work as educational early intervention centers. However, some of the early intervention centers are already staffed on an interdisciplinary basis and are waiting for the announced state framework recommendations in order to be able to enter into negotiations with the funding agencies. The Schleswig-Holstein Medical Association has had an early intervention working group for years, an interdisciplinary body with the aim of qualitative and interdisciplinary development of early intervention. Years of work have resulted in various publications and a "key issues paper" on interdisciplinary early intervention.

Bavaria

The “Framework Agreement for the Early Detection and Early Intervention of Children with Disabilities and Children at Risk of Disability in Interdisciplinary Early Intervention Centers” has been in effect here since August 1, 2006. It was concluded between the Association of Bavarian Districts, the Working Group of the Health Insurance Associations in Bavaria, the sponsoring associations of interdisciplinary early intervention and the Bavarian Association of Statutory Health Insurance Physicians. Responsibility for the financing of early intervention in Bavaria was transferred on January 1, 2008 from the urban and rural districts to the districts.

literature

  • Ekkehard Bartsch (Ed.): Toy workshop (1,2 & 3) - do-it-yourself toys for disabled and non-disabled children . 2nd Edition. 1998.
  • Michael Baumgartner (eds.), Gisela Färber, Franz Michels: SPIKS - game card index for special and curative education . 4th edition. Verlag modern learning, ISBN 3-8080-0342-1
  • Anja Hoffmann, Norbert Kühne: early intervention - education under 3 years. In: Norbert Kühne : Praxisbuch Sozialpädagogik , Volume 6. Bildungsverlag EINS , Troisdorf 2008, ISBN 978-3-427-75414-5 , pp. 72–110.
  • Gerhard Klein: Early intervention for children with psychosocial risks . 2002
  • Jürgen Kühl: The young child's autonomy in early intervention . 2000
  • Annette Neubauer: Visual Perception. Puzzles and exercises for kindergarten . Loewe Verlag, 2004, ISBN 3-7855-5247-5
  • Annette Neubauer: Combination games. Puzzles and exercises for preschool . Loewe Verlag, 2005, ISBN 3-7855-5410-9
  • Lilli Nielsen : are you blind? Development support for visually impaired children. Ed. Bentheim, Würzburg 1992, ISBN 3-925265-39-2
  • Lilli Nielsen: The I and the space . Active learning in the "small room". Ed. Bentheim, Würzburg 1993, ISBN 3-925265-44-9
  • Lilli Nielsen: Grasp and you can understand . Ed. Bentheim, Würzburg 1992, ISBN 3-925265-36-8
  • Lilli Nielsen: step by step . Early learning of visually impaired and multiply disabled children. Ed. Bentheim, Würzburg 1996, ISBN 3-925265-52-X
  • Erna Seemann: Early learning as a job . 2003, ISBN 3-7815-1282-7
  • Walter Straßmeier: Concrete early support - 260 practical life exercises for children with developmental retardation and handicapped children . 5th edition, 2003
  • Martin Thurmair, Monika Naggl: Practice of early intervention - introduction to an interdisciplinary field of work . 2nd Edition. Ernst Reinhardt Verlag, Munich 2000.
  • Journal: Interdisciplinary Early Intervention

Web links

Individual evidence

  1. ↑ An example of early support for normal talent is reading support in kindergarten and primary school.
  2. ^ [1] The development stage model according to Piaget