An Early Intervention for Children with Developmental ... · An Early Intervention for Children...
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An Early Intervention for Children with Developmental Disabilities in Vietnam Jin Y. Shin and Nguyen Viet Nhan Hofstra University, New York, U.S.A. and Hue College of Medicine and Pharmacy, Hue City, Vietnam Introduction An estimated 150 million children in the developing world have some kind of disability (Durkin, 2002; UNICEF, 2005) and suffer the double burden of poverty and disability. There are scant educational services available for these children. The objectives of this project were to conduct a home- based early intervention for children with intellectual disabilities in Vietnam and to explore ways of developing effective and sustainable intervention strategies in developing countries. Methods Participants Participants were thirty parents and their children of ages three to six who were identified as having intellectual disabilities /delays by teachers in kindergarten programs or by records of community health clinics. The mean score of the thirty children on the Vineland Adaptive Behavior Scale (Sparrow, Ball, & Cicchetti, 1984) was 52.6 with a range of 30 to 69, which placed them in the mild to moderate mental retardation range according to the U.S. norm. Sixteen of the children were assigned to a one-year intervention group and fourteen to a no-intervention control group, matched by gender and age. There were no significant differences between the intervention and control groups in any of the domains of the Vineland scale at 0 month. Procedures The Portage Model was originally created to provide home-based services to young children with disabilities in rural communities in the U.S. It has been widely adopted internationally, especially in developing countries. It has been an effective program in training parents to work with their children where there are no professional resources available and no physical entity for center-based programs exists. Protocols for Parent Training Typically teachers held a weekly one-hour session, which was broken down into three manageable components. First, they reviewed the homework assignment by having the parents demonstrate the previous assignment with their children. Second, the teachers reviewed new teaching objectives with the parents and demonstrated the steps to achieve a desired behavior. Third, these new objectives became the newly assigned homework for the parents. A Measure for Child Development The Vineland Adaptive Behavior Scales-Parent Survey Form (Sparrow et al., 1984) was used to assess the children’s development over the one-year intervention period. The scale provides a measure of adaptive behavior in the domains of communication, socialization, motor skills and daily living. When the validity of the Vietnamese version was assessed (Dill et al., 2009), a third-order confirmatory factor analysis supported the construct validity of the scale. Reliabilities of the scale measured by Cronbach alpha ranged from .92 to .97. Results Repeated- measures MANOVAs were computed to examine group difference on four domains, eleven subdomains, and overall adaptive behavior composite scores of the scale. There were significant group x time effects over the course of one year in the areas of personal care and motor skills (Figures 1 & 3). In these areas, the intervention group improved significantly more than the control group. Although the results were not significant, the overall patterns of scores in daily living skills and the adaptive behavior composite scores showed that the intervention group appeared to make greater gains than the control group (Figures 2 & 4). Discussion The results are promising in that the children appeared to benefit from the intervention, especially in the areas of daily living and motor skills. These are the skills important for independent living and for relieving severe caregiving burdens. All that was needed to improve the daily living skills of the majority of children with intellectual disabilities were teachers, easy-to-follow manuals and trained supervisors who provided hands-on support to teachers. Our experiences in Vietnam show the feasibility of implementing an intervention program for children with intellectual disabilities within the context of the developing world, where resources are limited. Figure 1 Figure 2 Figure 3 Figure 4
Transcript of An Early Intervention for Children with Developmental ... · An Early Intervention for Children...
An Early Intervention for Children with Developmental Disabilities in Vietnam
Jin Y. Shin and Nguyen Viet NhanHofstra University, New York, U.S.A. and Hue College of
Medicine and Pharmacy, Hue City, Vietnam
Introduction
An estimated 150 million children in the developing world have some kind of disability (Durkin, 2002; UNICEF, 2005) and suffer the double burden of poverty and disability. There are scant educational services available for these children. The objectives of this project were to conduct a home-based early intervention for children with intellectual disabilities in Vietnam and to explore ways of developing effective and sustainable intervention strategies in developing countries.
MethodsParticipantsParticipants were thirty parents and their children of ages three to six who were identified as having intellectual disabilities /delays by teachers in kindergarten programs or by records of community health clinics. The mean score of the thirty children on the Vineland Adaptive Behavior Scale (Sparrow, Ball, & Cicchetti, 1984) was 52.6 with a range of 30 to 69, which placed them in the mild to moderate mental retardation range according to the U.S. norm.
Sixteen of the children were assigned to a one-year intervention group and fourteen to a no-intervention control group, matched by gender and age. There were no significant differences between the intervention and control groups in any of the domains of the Vineland scale at 0 month.
ProceduresThe Portage Model was originally created to provide home-based services to young children with disabilities in rural communities in the U.S. It has been widely adopted internationally, especially in developing countries. It has been an effective program in training parents to work with their children where there are no professional resources available and no physical entity for center-based programs exists.
Protocols for Parent Training Typically teachers held a weekly one-hour session, which was broken down into three manageable components. First, they reviewed the homework assignment by having the parents demonstrate the previous assignment with their children. Second, the teachers reviewed new teaching objectives with the parents and demonstrated the steps to achieve a desired behavior. Third, these new objectives became the newly assigned homework for the parents.
A Measure for Child Development The Vineland Adaptive Behavior Scales-Parent Survey Form (Sparrow et al., 1984) was used to assess the children’s development over the one-year intervention period. The scale provides a measure of adaptive behavior in the domains of communication, socialization, motor skills and daily living. When the validity of the Vietnamese version was assessed (Dill et al., 2009), a third-order confirmatory factor analysis supported the construct validity of the scale. Reliabilities of the scale measured by Cronbach alpha ranged from .92 to .97.
Results
Repeated- measures MANOVAs were computed to examine group difference on four domains, eleven subdomains, and overall adaptive behavior composite scores of the scale. There were significant group x time effects over the course of one year in the areas of personal care and motor skills (Figures 1 & 3). In these areas, the intervention group improved significantly more than the control group. Although the results were not significant, the overall patterns of scores in daily living skills and the adaptive behavior composite scores showed that the intervention group appeared to make greater gains than the control group (Figures 2 & 4).
Discussion
The results are promising in that the children appeared to benefit from the intervention, especially in the areas of daily living and motor skills. These are the skills important for independent living and for relieving severe caregiving burdens. All that was needed to improve the daily living skills of the majority of children with intellectual disabilities were teachers, easy-to-follow manuals and trained supervisors who provided hands-on support to teachers. Our experiences in Vietnam show the feasibility of implementing an intervention program for children with intellectual disabilities within the context of the developing world, where resources are limited.
Figure 1 Figure 2 Figure 3 Figure 4
