Early Intervention in Europe Helmut Heinen Managing Director Office for People with Disabilities German-speaking Community of Belgium Budapest, 8 th March

Early Intervention in EuropeEarly Intervention in Europe

Helmut HeinenManaging Director

Office for People with DisabilitiesGerman-speaking Community of Belgium

Budapest, 8th March 2010

OFFICE FOROFFICE FOR

PERSONS PERSONS WITH DISABILITIESWITH DISABILITIES

2

Early Intervention in Europe: BasesEarly Intervention in Europe: Bases

UN-Convention of 13 December 2006 on the Rights of Persons with Disabilities

Council of Europe Action Plan to promote the rights and full participation of people with disabilities in society: improving the quality of life of people with disabilities in Europe 2006 – 2015"

Early Intervention in Europe – Budapest, 8th March 2010

3

UN-Convention on the Rights of UN-Convention on the Rights of Persons with DisabilitiesPersons with Disabilities

Article 23: Respect for home and the family

“3. States Parties shall ensure that children with disabilities have equal rights with respect to family life. With a view to realizing these rights, and to prevent concealment, abandonment, neglect and segregation of children with disabilities, States Parties shall undertake to provide early and comprehensive information, services and support to children with disabilities and their families.”


4



“4. States Parties shall ensure that a child shall not be separated from his or her parents against their will, except when competent authorities subject to judicial review determine, in accordance with applicable law and procedures, that such separation is necessary for the best interests of the child. In no case shall a child be separated from parents on the basis of a disability of either the child or one or both of the parents.”


5



“5. States Parties shall, where the immediate family is unable to care for a child with disabilities, undertake every effort to provide alternative care within the wider family, and failing that, within the community in a family setting.”


6


Article 25: Health

“States Parties shall (…)

(b) provide those health services needed by persons with disabilities specifically because of their disabilities, including early identification and intervention as appropriate, and services designed to minimize and prevent further disabilities, including among children and older persons;

(c) provide these health services as close as possible to people’s own communities, including in rural areas (…)”


7


Hungary ratified the Convention on 20 July 2007

Belgium ratified it on 2 July 2009

Today, a total of 11 countries of the European Union ratified the Convention.


8

The Council of EuropeThe Council of Europe Disability Action Plan Disability Action Plan

On 5 April 2006, the Council of Europe member states adopted the

"Action Plan to promote the rights and full participation of people with disabilities in society: improving the quality of life of people with disabilities in Europe 2006 – 2015"


9


Objectives:

to translate the aims of the Council of Europe with regard to human rights, non- discrimination, equal opportunities, full citizenship and participation of people with disabilities into a European framework on disability for the next decade.

to provide a comprehensive framework that is flexible as well as adaptable in order to meet country-specific conditions.

With its specific actions by member states it provides for the concrete implementation of the UN-Convention


10


The Action Plan puts down for Early Intervention:the need to ensure high-quality early

intervention, a multi-disciplinary approach, from birth, including support and guidance for the parents.

the importance to establish effective measures to detect, diagnose, and treat impairments at an early stage, and also to develop effective guidelines for early detection and intervention measures.


11


The Action Plan also stresses the importance of parents’ training, i.e.:to ensure that parents of children with

disabilities can have access to suitable training enabling them to acquire the empowerment for leading a life as close as possible to normal with their disabled child

to therefore thoroughly assess the needs of families as providers of informal care, especially those with children with disabilities, with a view to providing information, training and assistance, including psychological support, to enable an ordinary life within the family.


12


Finally, the Action Plan also emphasizes the importance of initial and ongoing training for professionals

It will be necessary to work out a programme for the implementation of this Action Plan in each of the 47 Council of Europe member states.


13


• Early Intervention in Europe is rather a patchwork of nationally, even regionally, differing policies.

• A systematic evaluation of its structures had been lacking.

• At the beginning of the 21st century, Eurlyaid sent a catalogue of questions on the subject of their national framework for Early Intervention to 24 services in 13 countries of Western Europe.

• Hereafter the main results …


14


Early intervention is offered in most of these countries with some exceptions where it is not at all or only partially provided for.

Providers are for the most part NGOs and non-profit organisations, but also public authority providers

Different finance forms: Early intervention is financed in all 13 countries by

the state, although to differing degrees(from 0.30€/inhabitant to 3.00€/inhabitant)

Parents’ participation per session (in some countries)

Many institutions enjoy additional support through donations


15


The majority of countries have Early Intervention-centres, which offer outpatient and/or mobile services in the families.

Catchment areas differ widely (from 50,000 to 600,000 inhabitants per facility)

Average facility size: the norm is from 50 to 200 children

Considerably varying rates of children calling on Early Intervention services: from 0.02% to 3%.

Children’s age: in the average from birth to kindergarten or school age


16


Type of disabilities: Most facilities are open for all disabilities; some are specialized in mental, sensorial or physical disability; only a few include children showing behavioural disturbances

Early Intervention teams include: medical doctors psychologists medical therapists (speech therapists, physio-

therapists,…) educational staff social workers and assistants psycho-motoric therapists nurses other specialists, depending on the institution’s

particular focusEarly Intervention in Europe – Budapest, 8th March 2010

17


Who sends families to Early Intervention facilities? generally, other specialists by own initiative schools or kindergartens financing authority


18


All institutions questioned cooperate with mainstream centres and organisations such as: paramedics day nurseries schools.

mainstreaming


19


To summarize:

Structure of Early Intervention: extraordinary varying from country to country but similarity of basic structure

Type of approach in the intervention: disability-oriented, classic-medical intervention

(particularly in clinical facilities) Educational (pedagogical) intervention, which

is more strongly oriented toward the child’s environment

This distinction also has an effect on the structure of care being offered.


20


Goal must be: to support the professional common ground between these two tendencies and thereby force a synthesis between them.

In addition: structures which induce cooperative commitment between the different professions (importance of our discussion on multi-, inter-, and trans-disciplinary consciousness and its application in practise).


21


Medicine = the necessary foundation, psycho-pedagogical aspects = more consistent application in care-giving.

The goals must be: reinforced context and resource orientation; a more consequential approach to autonomy in

intervention; the transformation from control and training

programmes to self-help empowerment.


22


A wide gulf still separates these two professional requirements and their practical application within the resources of the facilities themselves; within the actual competence of the professional

caregivers: a lack of competence leads to a need for security and an exaggerated concern with the deficient aspects of both child and family


23

Challenges for the futureChallenges for the future

1. What comes after early detection?

A main challenge is that Early Intervention becomes active at that stage and

• shows parents concerned the possibilities of how families may live with disabled children;

• empower parents so that they may lead a life as close as possible to normal with their disabled child and take the necessary decisions in knowledge of their child’s reality.


24


2. Early Intervention for families belonging to the disadvantaged sections of population These families are increasingly not able to

assume their parental mission, even though their children only present a hardly provable disability.

In this context, it is necessary to assure prevention to avoid that these families drop out of the social system.


25


3. Initial and ongoing training for professionals Promoting structures which induce

cooperative commitment between the different professions

Promoting a more consistent application of the educational aspects

Increased call on mainstream services and institutions and therefore empower-ment of these services and institutions to work in a complementary way with Early Intervention services.


26


4. Early Intervention in cultural minorities

5. New forms of disability

6. Child abuse and child abandonment inflicted by the family

In Europe, there are indications that the rate of abuse, violence, and abandon-ment of children with disabilities by their families is considerably higher than the rate for non-disabled children, and this due to the fact that a lot of family members are not able to handle the situation of living with a disabled child.


27


7. In a time of restructuring and financial shortages, Early Intervention must find its consolidated place in the social sector. It is of utmost importance that Early

Intervention is not only offered in times of financial abundance !

Early Intervention is no luxury but an elementary necessity for children with disabilities and for their families.


28


We must not forget that it is perhaps even more cost-effective to invest at the beginning of a child’s life and to activate and empower the family in their own creativity and dynamics for a life with a disabled child.This avoids, on the side of the family, resignation and a posterior waiting for full state presence and/or consequently institutionalisation.


29


8.To secure a further financing, we urgently need studies examining the impact of Early Intervention on :– the development of children with

disabilities and on their possibilities to live their life in an autonomous and self-determined way

– the quality of life of families with disabled children.

9.Furthermore, we have to assess the impact of Early Intervention on the inclusion of disabled people in society.


30

To concludeTo conclude

• Past experience shows: By all working together we are able to achieve so much more! We should continue to gather our strength.

• Cooperation between Western, Central and Eastern Europe is highly enriching. Cooperation between Hungary and Belgium proves this – just take the Petö method that is also applied in Belgium.


31

To concludeTo conclude

• So, let us reinforce our cooperation to enrich each other through our differences and our strengthes in fields such as f. ex.:- desinstitutionalisation- outpatient advice, guidance and relief

services- training or retraining for professionals.


32

Thank youThank you

for your attention.for your attention.


33

Office for People with DisabilitiesOffice for People with Disabilities


Vennbahnstraße 4/4

B-4780 ST.VITH

Tel.: 080/229.111

Fax: 080/229.098

www.dpb.be

[email protected]

Documents

Early Intervention in Europe Helmut Heinen Managing Director Office for People with Disabilities German-speaking Community of Belgium Budapest, 8 th March