Recognition of the importance of brain development in the early years of life has led to expanded early intervention programs for very young children with or at risk for developmental disabilities throughout the world. Recent developmental brain research suggests a plausible biological basis for early intervention. However, specific intervention practices must be judged on their efficacy, effectiveness, and cost justification. Early intervention has made important shifts in emphasizing social competence in the child and the essential role of the family and community.
“A Stitch in Time Saves Nine” - —Proverb
The world in recent years has focused increasingly on early intervention for infants, toddlers, and young children. Even in those countries where infant survival remains the highest priority, governments and international relief agencies recognize that living fully is as important as not dying.1 There is no more important period in human development than conception through early childhood in maximizing the potential for living fully. The more we learn about brain development, the more this point gains poignancy.
The goal of early intervention is to prevent or minimize the physical, cognitive, emotional, and resource limitations of young children disadvantaged by biological or environmental risk factors. Whereas interventions for older children and adults with similar limitations focus on the individual, an important premise of early intervention for young children is the key role of the family. Without involvement of the family interventions are unlikely to be successful. Oftentimes, the target of the intervention must be the family even though the primary concern is about an infant's poor growth, atypical behavior, or delayed development. Such a child is unlikely to thrive in any of these domains if the family is stressed by parental unemployment, unsanitary living conditions, or neighborhood violence.
“It takes a village to raise a child” said U.S. Senator Hillary Rodham Clinton, quoting an old African proverb.2 Children will thrive only if a society cares enough to support families. A family alone, a health worker alone, a therapist alone, a social worker alone is unlikely to achieve the success that might be possible through involvement and coordination of the community.
These two elements—family and community—are key to the success of early intervention. In this article the author will review concepts about the sensible and scientific bases for specific components of early intervention. Yet, without family support and coordinated community involvement, any single activity will not achieve the goal of optimal development for a given child.