Professional Education in Early Intervention Syste

See discussions, stats, and author profiles for this publication at: https://www.researchgate.
net/publication/237770366
Professional Education in Early Intervention Systems in Europe An overview
Article · January 2005
CITATION READS
1 84
1 author:
Aleksandra Dimova
Psychiatric Practice: Dr. Dimova
14 PUBLICATIONS 26 CITATIONS
SEE PROFILE
Some of the authors of this publication are also working on these related projects:
Acute response to stress: extended version of sequance order View project
It is case report View project
All content following this page was uploaded by Aleksandra Dimova on 29 April 2016.
The user has requested enhancement of the downloaded file.

Professional Education in Early
Intervention Systems in Europe
An overview
Aleksandra DIMOVA (PhD)
Graz, January 2005
The Project EBIFF is supported by the European Commission within the framework of Leonardo da Vinci 1
and by the Ministry of Culture, Science and Education of Austria
Content:
0. Preliminary remarks
1. The focus on the issue of professional training
1.1 An example of the professional reality
1.2 An overview of the training situation
2. The situation within the European Member states
3. The challenge
4. The requirements for professional education
4.1General personal requirements including working in teams
4.2 Communication skills
4.3 General knowledge versus specialisation
5. The European Perspective
6 Perspectives
7.References:
0. Preliminary remarks
This reports is part of a larger project to increase the quality of professional training in Early
Childhood Intervention. Even though this report focuses primarily on European support
system for children with special needs, from socially disadvantaged families or at the risk to
become disabled, I would like to remind, that there is a still unattended group of children,
which in most European Early Childhood Systems doesn´t obtain adequate support.
As described in Pretis/Dimova 2004 beside traditional Early Childhood Intervention the group
of children, living in the context of a mental disorder of parents, should not be “forgotten.
This group of forgotten children – in terms of support of resilience factors – also has major
impact on the issue of professional training.
1. The focus on the issue of professional training
During the last years, in Europe, especially after the general consensus that Early Childhood
Intervention (ECI) shows – at least – short term effects (Guralnick 1997, Schlack 1991,
Shonkoff et al. 1992), an increased interest in the issue of professional education has become
evident (Helios-program, Eurlyaid, European Agency).
Both specificity and complexity of ECI were pointed out clearly, stating that ECI includes
professional activities
- In different interacting systems (child, family, siblings, grandparents, involved
professionals..)
- Which require the transdiciplinary integration of information (Pretis 2001). ECI –
mostly within transdiciplinary teams – have to create a consensual reality and
intervention strategy. Theoretical models, hypotheses and concrete interventions
derive from different fields. The transaction of knowledge between the involved
professionals, e.g. from the field of neuropeadiatry, speech therapy, special education,
developmental psychology, seems to be a higher challenge than the work with the family.
- Which focus on highly specific knowledge, e.g. family counselling, early childhood
development, systematic interventions
- Which require teamwork competence (e.g. mutual respect, ability to listen to one
another, transparency of the own model, understanding the language of others…)
In Europe the current discussions about the professional education and quality of services can
be seen as a result
a) That the implementation of ECI-systems in European countries seems to be finalised:

In most of the European countries – despite a high degree of organisational diversity –
ECI systems are institutionalised. Defining structures in a more systematic way
(access to ECI, basic requirements and standards …) is generally a further logical step
within processes of institutionalisation.
b) That an increased economical pressure over social programmes and the need to
evaluate effects can be observed (Pretis 2001). In contrast to the American situation
(Sheehan 2004) this evaluation process is still associated, in most European countries,
with the aspect of control. In the majority of European countries, or from the side of
the services or the responsible financial bodies, increased efforts to define the quality
of ECI (Pretis 2003) can be observed.
c) That there is a gradual change concerning the role of the key-players: especially in
urban areas, parents’ communication with professionals increasingly centres around a
consumer model. “Parents do not seek help or support. only services”, as one parent
recently stated during an ECI conference (Brussels 2004). Consumers claim the right
to obtain products and services that are “good enough”. However, due to numerous
restrictions, totally liberalised markets in the field of social work should be interpreted
with caution. For example: One goal of liberalised markets is “customer binding”. On
the other hand a main goal of preventive social programmes is empowerment and
autonomy, which means an independence of services. Minimal monitoring processes
of governmental systems – especially in ECI as a very intimate and family-intrusive
intervention (if mainly home based) – will be necessary.
1.1 An example of the professional reality
The working situation of the professionals themselves requires a range of skills: An example
of a time table of an Austrian ECI professional might point out necessary skills:
Table 1: Timetable of an ECI professional based on an Austrian situation

Day Activity Required skill
Monday 7:30- Preparation of the units Creation of a working plan,
8.15 hypothesis
(8:30-10) ECI unit with a very low birth weight Information about VLBW
child (VLBW), still in the neonatal Counselling the parents (what are
ward they able to do at this stage)
Reflection with the neonatologist
10.20 – 11.50 ECI unit with a child (3; 6) with Specific knowledge about ADHD
ADHD at home Information for the parents
Work with parents (structure,
behavioural contingency, rewarding
systems at home)
12.00 – 12.30 Break, reflection of the units, Self reflection
documents
13.40-15.10 ECI unit with a child with Specific knowledge
Down’ssyndrome planning to attend Information about the network and
a kindergarten legal requirements (which
kindergarten is suitable…)
15.30-17.00 ECI unit with a child with unclear Knowledge about specific exercises
developmental delay, sibling at and items, developmental screening.
home. Inclusion of the sibling
Family situation could be described Respecting the family’s values and
as disadvantaged beliefs
17.00-17.30 Reflection and documentation of the

units
Based on this short description it is not surprising that
a) Professionals have high demands within their jobs (average duration of work within
the field in Austria: 6 years) and that
b) They ask for specific education, primarily in 2 areas: Specific intervention methods
and counselling techniques of working together with parents.
1.2 An overview of the training situation
Some efforts to create a comparable curriculum for ECI professionals within European
professional training initiatives (www.eqm-pd.com) can be observed, but in most countries
systematic training activities are still nonexistent, as table 2 shows. However the scientific
community shows great effort to increase the quality of the training situation:
To mention some initiatives:
- discussion of a curriculum for professionals in Germany (VIFF 2005)

- discussion of a full master degree at the University in Barcelona (2005)
- A whole edition of the Journal “Infants and Young children” based on the topic of
training issues (3/2005)
These efforts reflect the sensitivity on behalf of the topic. Before describing the detailed
situation in the European member states, an overview is presented. This overview indicates,
that there can be observed some local initiatives, but no common strategy.
Table 2: The situation in some European countries (summarised analysis of the European
Agency 2003-2004)
Country Involved professionals Specificity of Organisation of Comment

y education training
Austria “Early Interventionists” as Partly (4 of 9 Further Specific further
a profession, provinces) education, 2 education as a
psychologists, special university pre-requisite to
educators courses, 1 NGO be work
Czech Local specialised health Depends on In-service Training in team
Republic (MD, nurse) and social basic training management,
service (social worker); education co-operation
education (pedagogues, needed
psychologists, speech
therapists…)
Denmark Health professionals More
(nurse), education systematic
(pedagogues and training is
psychologists) and social required
service
Estonia Health services Training Master courses Training needs
(paediatrician, systems are being to focus more on
psychologist, need to be organised family needs
physiotherapist), created
educational (teacher…)
and social
Finland Health (nurse, MD), social More In-service Need to
and educational systematic training depends establish a well-
(psychologists, family training is on municipalities coordinated
counselling) required system, to
combine theory
and practice
France Depending on the form of Heterogeneous structures: Centre Médico Psycho
organisation (social, Pédagogique, Centre de prévention précoce, cures
educational, health) ambulatoires Precocious Medico-social Action Centre Child
and Mother Prevention
Germany Interdisciplinary teams, Different Special courses, Different
special educators, basic In-service systems within
therapists professions Training, partly the 16 “laender”
university (provinces)
courses
Greece Education: Most are part No official More co-ordination Many
of the pedagogical field, training between the professionals are
Social, Health and
Health: child psychiatrist, Educational
highly qualified,
speech therapist; Social: Services e.g. through In-
social worker Service Training
Lithuania Health and education Need to e.g. at the Training needs
professionals create University of to be more
systematic Siauliai focused on
training family needs
Luxembourg Professionals in the field No specific Training Need for further
of education (special training attended in education
educators), working neighbouring
together with social countries
workers
Norway Professionals in the field No specific Resource
of health (nurse, training Centres support
physiotherapist), social the local
work, education (special structures
educator, speech
therapist…)
Portugal Health: MD, nurses, Partly 3 Master Working in
therapists, Education: pre- specialised degrees, In- “inter-services”:
school teachers, child care Service training professionals
takers; social: social from different
workers services creating
a “team”
Spain Professionals in health, Postgraduate 6 Master degrees National
education and social courses coordination, In-
services service training
of new
professionals as
a challenge
Switzerland Professionals in the social Professionals
(special educators) and mostly
health area (MD...) trained in
special
education
2. The situation within the European Member states
Both – the issue of attending the children and the professional training within the European
context – is highly heterogeneous, therefore a simple comparision of the different systems is
not directly possible. The procedure of description therefore focuses on different parameters,
which seem to be – more or less – present in all European Early Childhood Intervention
Systems:
a) Quality/quantity of Centres
b) Age over the children covered by the systems
c) Involved professionals
d) Training Issues
This deatailled analysis serves as a basis for country- specific dissemination and
marketing strategies of the EBIFF-project.
AUSTRIA
Centres/ Names Number Age Respons- Comments Training issues
covered ibility (professionals involved)
Frühförderstellen (E.I. 80 0-3/7 Social Most professionals belong to the pedagogical The professionals in the EI centres are mostly (95%)
Centres) years field: basic pedagogical education + mostly ”pedagogues” (specialists, trained as early
obligatory further education (1200 hours) interventionalists-“Heilpädagogen”
Ambulatorien (Clinical 4 0- Health
E.I. centres co-operate with different therapists. Training is offered by Academies or Universities
Centres)
Key persons are paediatricians/ psychologists or (depending on the laws of different federal provinces).
social workers who do the assessment Training has to be financed mostly privately.
Sehfrühförderung (E.I. 8 0-7 years Social (diagnosis). Service is paid by Social System.
Centres for Visual “Children at home” Due to the lack of “care families”,
impairment) Special support is also provided in Kindergarten “nurseries”, day care centres for toddlers (0-3), children
(which is not part of EI-system) by means of stay “at home” until 2.5-3 years – including the political
integrated groups or mainstream inclusion. strategy of “kinder-geld” (450 Euro) till the child
Support “pedagogues” and therapists for the reaches 2.5 or 3 for 1 parent)
children with special needs in the kindergarten.
CZECH REPUBLIC
Services/institutions number Age Responsibilit Comments Training issues
covered y
Health care/hospitals, Local and Medical doctor – 6 years university studies

health centres 0 – 18 specialised Nurse – Higher vocational education – 7 years
years health Social worker – secondary ed. (4 years)
Social care/ special service
children homes, day care Social service In-service-training,
centres, contact social More systematic training based on the needs of child /
centres and offices for family. Training in team management, team co-
social counselling operation needed.
The Project EBIFF is supported by the European Commission within the framework of Leonardo da Vinci and by the Ministry of Culture, Science and Education of Austria 10
Nursery 6 months Health
– 24
months
Kindergarten – special 2 years – Education Local community administration;

kindergartens, special 6 years Municipality;
units within the regular Local community, municipality, regional school
kindergartens, individual authorities, Ministry of Education
integration
DENMARK
Centres/Names Number Age Responsibility Training issues

covered
Health Nurse after 0-9 Local administration Health Nurse education takes 6½ years.
hospital months Municipality
Family doctor Health Service More systematic training based on what
Social Service (But up to 2½ years if the child/ children/families need.
family needs it)
Pedagogical- 275 0-18 Local Personal development plans for professional.
Psychological Advice years administration
Centre (PPR) Municipality
Education Service
Social Service 275 0-18 Local administration
years Municipality
Social Service
Special groups in 0- 6 Local administration
kindergarten/day care- years Municipality
centre Social Service
Or region administration
ESTONIA
Centres/Names Number Age Responsibility Comments Training issues

covered
Early Rehabilitation 6 ( 364 0 -7 Education/ Law on Special Training needs
Services children) Health (local authority level) Kindergarten to be more focussed on family needs
from 1999
Special groups in In all 2 – 6/7 Education Law from 1999: Education Training system of E.I. professionals
mainstream authorities years (local authority level) Act 1992 needs to be created; independent consultation is needed
kindergarten (until
school)
University Child 1 1 – 10 Education (longit. research) Child development and
Development Centre years environmental conditions
FINLAND
Centres/ Names Number Age Responsibility Comments Training issues
covered
Maternity and Child In every 0 till Health Nurse + Doctor Information of risks, In-service training depends on municipalities.
Health Clinic municipalit school identification, heredity There is no well-established general system.
y/area age Psychologists, family- To combine theoretical and practical issues
Family counselling counsellors Children can attend any type of
Clinics 0 - 18 provision available from birth
years till school age.
Hospitals and Control These provisions are mainly
Points related to health under Social services.
nurses Therapies are also conducted in
Special Health Care private practices.
Health services and 0 - 18 Health + Social Education is involved through
Rehabilitation services years professionals like special
teachers or educators.
Day care centres, About 10 Social Education after
kindergarten (children 3000 month - 01.08.2003 = choice of
will be integrated and 3 years municipality
supported by consultative 3-5
special teachers, after years
diagnosis) 6 years
Special groups (f. ex. pre-
speech problems) school
Parents
can
choose
Provisions for Sensorial Private associations;
or intellectual Courses for Families;
impairment. These are Medical instruments
mainly case management
services.
Special Care Circles 0 - 18 Public administration
years
FRANCE
Organisation Age Responsibility Comments Training
Child and Mother 0-6 Direction Départementale de A free of charge medical Different institutions offering training (e.g.
Prevention (La l’Inspection Sanitaire et follow-up for 0-6 years old ANECAMPS in Paris)
Protection Maternelle et Sociale (Health/Social) children AIR in Besancon
Infantile) attached to Deoartments (98) Pediatric nurse can go at home
to see the infant Assessments in doctors and midwives,
school paediatric nurse
Precocious Medico- 0-6 Detection and prevention,

social Action Centre assessment at age 4 months, 2
(Centre d’Action Médico- years
Sociale Précoce
(CAMSP)
Cures ambulatoires Health and social Therapeutic interventions Doctors,
paediatrics,
(ambulant child psychiatrist,
therapies) psycho-motrician,
speech therapist,
physiotherapist,
psychologist,
ergo-therapist,
paediatric nurse,
administrative and social workers
Centre de prévention 0-6 Centre, a day nursery or parents MD, psychologist, pyhsiotherapist
précoce risk.
This centre can propose
medical hours, assessments
(psychomotricity, speech
therapy, psychology).for 0-6
years old children in sanitary
Centre Médico Psycho 0-20 Education Assisting issues of school- MD, psychogist, psychotherapist, Social Worker,
Pédagogique integration Educator
GERMANY
(example: Bavaria, as the situation in Germany due to the federal caracter is not comparable). See also the attempts of VIFF (2005) to define
guidelines regarding professional training.
Country number Age Responsibility Comments Training

Bavaria/Germany
Interdisciplinary Early 1200 0-6/7 Social Affaires, Families and *Children with all kinds of *Early Interventionists have different basic professions.
Intervention Centres (in Women disabilities and children at risk
general) *At University of Munich students get a certification in
State Ministry of Education and * Independent regional and EI after a 4-semester-course.
Culture family-oriented centres
Interdisciplinary Early *Therapists are offered special courses in EI mostly
Intervention Centres for 0-6/7 Local authorities *Interdisciplinary teams organised by the Bavarian “EI Support Centre”, or get
visually impaired/ blind (psychologist, pedagogue and supervision, or coaching (individual or in teams).
children NGOs medical staff) under
pedagog./psychol. leadership *Every year either a Bavarian or German congress in EI
takes place.
Interdisciplinary Early *Ambulant in the centres and
Intervention Centres for mobile work in the families *A lot of EI Centres are organising special in-service
hearing impaired/ deaf 0-6/7 /kindergarten training sessions.
children
*EI centres have special * Journal “Frühförderung interdisziplinär” provides
organization, financing and theoretical, empirical and practical overviews about all
principles of work issues on EI
GREECE
covered (professionals involved)
Infant and Counselling 3 0-4 Ministry of Health Most professionals belong to Many professionals are highly qualified and have
Centres for Deaf and the pedagogical field; they received an in-service training on family support, but
Hard of Hearing have been trained on the there is no official training on Early Intervention.
Children family centred approach.
(E.I. Centres)
Centre for Rehabilitative 1 0-4 Ministry of Health
Education for the Blind
(E.I. Centres)
Centre for Rehabilitative 1 2.5 – Ministry of Health
Education for the 4.5
Learning Disabled (E.I.
Centre)
Greek Organisation of 6 0-6 Ministry of Health
Support and
Rehabilitation for
Retarded Children (E.I.
Centres for children with
physical disabilities)
Specialised Care Centres 8 2-6 Ministry of Health
(E.I. Centres mainly for Child-psychiatrists, psychologists, occupational
children with autism and therapists, speech therapists, gymnasts, etc.
emotional problems)
Medical Pedagogical 88 0-18 Ministry of Health
Centres (provide
Diagnostic and Support
Services) Social Workers, Psychologists, Psychiatrists, Special
Diagnostic Assessment 54 0-22 Ministry of Education . teachers, Speech therapists, Physiotherapists,
and Support Centres (0-4 for Specialists in sign language, Mobility and orientation
(K.D.A.Y.) (E.I. Centres) EI) destructors
ICELAND

covered
Home visiting nurse Every 0-9 Health care centres Provision for very young
after child birth communit months children is similar in the
y Nordic countries.
The State Diagnostic 1 0-6 Ministry of Social Affairs
and counselling Centre years All children have the right to
Low Vision and 1 0 - all Ministry of Health attend any regular Training preschool teachers in early intervention.
rehabilitation Centre ages (mainstream) service from
Centre for Hearing 1 0 – all Ministry of Health early age to 6 years in Training early intervention specialists
Impairment ages preschools (provided by
Child and Adolescent 1 Childre Ministry of health Municipal services with due
Psychiatric Unit n – 17 support)
years
Regional Board for All All ages Ministry of social Affairs
affairs of the regions
Handicapped
Pedagogical In some 0 - 16 Municipalities in Iceland
Psychological Advice municipal years
Centre ities
Kindergarten, 253* 2 - 6** Municipalities in Iceland
preschools
* There are 105 municipalities and 30-40 Pedagogical Psychological Advice centres
** Most children stay at home from the moment of birth to 2 years old. Parental leave is about 9 months.
NETHERLANDS

covered
Child Health Centre 1465 0-4 Health (by Law: ABWZ) Target group are new born Medical Doctors,nurses trained for child health
children, vaccination, care
developmental screening (some elements of ECI are included in the initial
(hearing, visual, motor, training of special educators, social educators or
mental) pedagogues). Furthermore Master in Special
Child Welfare 5 0-18 Health/Social Security, Children in need for child Education (University Groningen)
Justice, Child protection protection Lawyers, behavioural scientists, welfare workers
Integrated Early 43 0-4 By law: ABWZ Children with
Intervention Teams developmental/motor Behavioral scientists, rehabilitation doctors, social
handicap workers
Social Educatinal 0- ABWZ Mentally and physically
Services handicapped people, living Behavioral scientists, home teachers, social
at home workers
Child Rehabilitation 0 - 18 ABWZ Children with Motor Medical oriented, rehabilitaion doctors,
Centre disabilities physiotherapists, occupationa therapists
Day care Centres 0-6 ABWZ Children with
mental/complex handicap Group educators/home teachers
Early Detection of 55 0-7 ABWZ Assessment + coordination Behavioral scientists, medical doctors, social
developmental delay workers
Child Psychiatry 12 0 - 18 ABWZ Children with disorders in Child psychiatrists, Behavioral scientists social
autistic spectrum workers
Institute for Deaf 3 0 - 18 ABWZ Deaf children Behavioral scientists, home teachers, social
workers
Institute for Blind 1 0 - 18 ABWZ Blind children Behavioral scientists, home teachers, social
workers
LITHUANIA
Centres/Names Number Age Responsibility Comments Training issues
covered
Early Rehabilitation 35 0 - 4/ 6 Health (local –authority There is a Law on Special Training needs to be more focussed on family
Services years level) Education (1998) and also needs.
University Child 2 0 - 18 Health (republican level) Regulations about E.I.
Developmental years (2002) It is too much based on a deficit model instead of
Centres Law of child care (1998) the project of a child and a family focus
Special Educational In some 2 - 6 Education (local – authority
Centres for severe authorities years) level) (till entering school Training system of E.I. professionals needs to be
physical and multiple created.
disabilities
Centres for Visual In some 2–6 Education (local – authority ECI part of the Master Study “Special Education”
impairment authorities years level) (till entering school) at the University of Siauliai
Centres for Hearing In some 2–6 Education (local – authority
Impairment authorities years level)
Specialised groups in In all 2–6 Education (local – authority (till entering school)
mainstream authorities years level) (till entering school)
kindergarten
Pedagogical – 1 2 - 18 Education (republican level)
Psychological Centre years
Pedagogical- 28 2 - 18 Education (local – authority
Psychological years level)
Services (PPS)
Infant homes 6 0-3 Health (republican level)
(social risk)
LUXEMBOURG
Age
Centres/Names N Responsibility Comments Training issues
covered
1a) Service de 1 0-4/5 Health Until 5, when the child is not There is no professional who would have all the EI
Rééducation Précoce able to go to school because of knowledge (on normal development of the child,
1b) Help for the baby 1 Health socio- emotional development variation of normal development and pathological
"Hëllef fir de South and East of Luxembourg Children with physical and development, mourn working, family needs, teamwork).
Puppelchen" mental handicap, with emotional So everyone should have the possibility to benefit from
2) Service d'Intervention 1 0-4 also Family Ministry and behavioural difficulties, further education.
Précoce till 6 years children with orthopaedic
Orthopédagogique problems and children at risk
(pre-born children and social
risks)
School for Visual 1 From 3 Ministry of Education till end of school age
Impairment years
School for impairment/ 1 From Ministry of Education

Language and special birth to
impairment end of
school age for detection and training of
Service 1 All ages Ministry of Health hearing impairment and speech/
audiophonologique language impairment
mostly highly trained professionals (in their different
Service d'orthoptie & 2 All ages Ministry of Health for detection and training of fields), but the specialisation in early intervention is
pléoptie visual disabilities normally an in-service training (orhtopie)
For some time now, pedagogical visual training for
young children under 3 years is lacking
Consultations pour Every 0-1 years Private institution Voluntary, (Consultation for
nourrissons community (partially financed by the babies: mostly on physical
Ministry of Health) development).
NORWAY
Centres Numbers Age Responsibility Comments Professionals
covered
Maternal and Child All 439 0–1 Local authority level Assessment and Guidance Health nurse and Physiotherapist
Health Centres municipal (18 (Special Educator)
ities years) Public Health Service
Social security office All 439 0 – 100 Local authority level Guidance about daily care Social worker
municipal years Public Social Service and financial support
Child Care ities
Pedagogical/ About 360 0-18 Local authority level Assessment and guidance of Special educator, Speech Therapist, Psychologist
psychological offices (joint years or parents and professionals Social Worker
(PP-offices) offices) more Local education Service
19 0-18 Heath/ State owned: (1 Assessment, guidance of Multidisciplinary
counties years centre/ parents/ local authorities
county)
17 0-100 Supervision of parents/ Special educator, Psychologist,
years Education system: centres, local authorities Physiotherapist, Social worker
with different professional
fields (e. g. E.I, visual, deaf/ System oriented
hearing) competence building
Habilitation Centres for All 0–18 State owned Assessment, Treatment, Special educator
Children counties years Supervision Psychologist,
Social worker
Support System for
Special Needs/
Resource centres
SPAIN
Country Age Responsibility Training
Child Development & 0-4/6 Social (regional authorities Sectored, regulated by EI Health
Early Intervention years regional plans, variable
Centres (CDIAT) composition and functions Neuro-paediatric, Rhb., Specialists, Paediatricians
usually depending on welfare Psychiatrists, Physio therapists, O. Therapists
regional authorities & Social or
Disability Laws. Education
Family-centred Teachers, PT teachers, AL teachers, Psychologists, Ed.
Early Intervention Teams 0/3-6 Education Reach all over the country, Psycholog
(EOEPS/ EATS) (Regional authorities) sectored, regulated, depending
on educational authorities & Social Services:
SEN educational laws
Education-centred Physicians, Social Workers, Psychologists, Ed.
EI units 0-6 Health (hospital services) Psycholog., ‘Psicomotricistas, Speech therapists
(Babies at risk,
prematurity, PCI, Autism, Education (Special Education
Down, Blindness and low Centres) There are enough postgraduate courses (10 Master)
vision, Deaf…) There is a national group for co-ordinating postgraduate
Social (NGO’s & parents course/supervisions
associations) In-service and contextual training of new professionals
is a weak point
Private practice More training in teamwork, family and community
dynamics and specific evaluation /intervention
techniques is demanded
PORTUGAL
Country Age Responsibility Training
Nursery/Child Care/Child 0-2 years Health Child care takers,
minders
Pre-school) 3-6 Education Preschool teachers
Health Centers 0- Health Including hospitals (e.g. Pediatricians, Family Doctors Few psychologists,
developmental consultations, psychiatrist, nurses, interservices
therapies)
Special Support teams 3-6 Education Home/nurseries and Preschool Some specialiced, some not
support
Psychology and Guidance 3-6 Education Psychologists
Services
Special Support Units for 3-6 Education Deaf children e.g. sign-language teachers
Deaf
Rescource Centers for 3-6 Education
multiple handicapped
Early Intervention 0-6 Education Partly interservices (PIIP) Interdisciplinary teams coming from different services
Projects and Direct teams
Local Service for Social 0-6 Social Social workers
Support
NGO-based special 0-6
education Institutions
Child Protection Centers 0-6 Partly specialised
Private medical or 0-6 Private Different professionals
psychological or
therapeutical support
SWITZERLAND
Centers
Names Age
Number Responsibility Comments Training issues
covered
Some of the centre are

birth - 7 The majority of the professionals are trained in special
E.I. Centre 109 Social organized by private E.I.
years needs and further in pre-school education.
professionals
birth - 7
years
E.I. Centre for hearing Some of the centre support the The professionals must have an training in Hearing
11 or end Social
impairment children in the mainstreaming disability and should be trained in pre-school education
of
school
birth -
E.I. Centre for visual Some of the centre support the The professionals should be trained in special needs
7 end of Social
impairment children in the mainstreaming and further in preschool education
school
birth -
E.I. Centre for physical Some of the centre support the The majority of the professionals are trained in special
2 end of Social
impairment children in the mainstreaming needs and further in pre-school education
school
Responsibility for first
diagnostic and referral
0 -7 The professionals are trained for medical special
Clinical Centre 11 Health Most E.I. professionals
years knowledge
wish more cooperation with
the medical specialists
3. The challenge
ECI is based on methodological openness (Weiss et al. 2004), making it difficult to identify
one single professional intervention strategy as the most adequate one. Furthermore –
especially concerning transdisciplinary work – a latent discussion between different
methodological approaches can be observed: Well established professional structures rely on
well-defined methodologies and terminologies (medicine, psychology.) and empirically well-
proven intervention methods. Social, empirical (e.g. special education) or environmental
approaches (systemic therapies) also include transactions and self-organising structures,
therefore sometimes do not show the same specification of terminology. Transdiciplinary
work within this context requires a lot of communication and teamwork. As ECI can be
regarded as one of the most complex social interventions (Speck 2000), effects – primarily
concerning children with severe disabilities – are dependent on proper coordination of support
teams (Shonkoff et al. 1992). The effects rely much more on the ability of the relevant
systems to meet the needs and strengths of the family: Whether it is possible to include
intervention models into the daily life of the child and the family. This requires ECI to be
- Understandable for the family (in terms of the language and theories used)
- Acceptable (in terms of values) and
- Transferable to daily life
Despite the diversity of possible theoretical approaches (specific therapies like physiotherapy,
holistic empowerment programmes in terms of special education, developmental stimulation,
systematic family therapy…) ECI is primarily based on an individual hypothesis-creation
process. The very starting point is the specific situation of a family in need of a special
support service. In addition to former approaches, which primarily rely on the diagnosis of a
child as a pre-requisite for ECI, a needs/strengths related model also includes existing
resilience factors: In addition to findings of the 2nd generation research, one can suppose that
not every family with a child in need for special support will need ECI. If – also from
family’s point of view – enough resources and resilience factors are present, intervention
strategies have to be defined with caution. The existence of a diagnosis – per se – cannot be
regarded as the only pre-requisite, especially in families with psychiatric disorders (Pretis &
Dimova 2004). It is a challenge, to find the right balance between the needs of the family and
the intervention possibilities of ECI. This aspect can be seen as the link between cost-
efficiency discussions, quality of the services and the issue of professional training.
4. The requirements for professional education
4.1General personal requirements including working in teams
As professionals might work in the intimate context of a family – including different systems
of values, cultural or religious backgrounds or even languages (migrant families), personal
stability could be assessed as a conditia sine qua non in the field of ECI. In some parts of
Austria professionals working in the field have to be at least 25 years old and are required to
have 2 years of experience in the social/medical/educational field. Furthermore, ECI
professionals represent a two-faced picture for the family: On the one hand they will become
active if a disability or a risk is detected (representation of worry, possible disability), on the
other hand parents also expect ECI experts to come up with a single solution (prevention,
training). During the process of ECI these representations may change, mostly in combination
with crises (Pretis 1999).
Personal stability includes
- Coping with stress and crises (e.g. coping with diagnosis and prognosis)
- Adapting the role of the professional to heterogeneous demanding situations
- Working, at times, in difficult surroundings (especially concerning disadvantaged
families)
- Working with limited institutional equipment, especially in the services that primarily
offer home-based intervention programmes
- Every-day know-how in terms of independence and being grounded in life
- The ability to reflect on your own methodological approach
- Working in teams and sharing responsibilities
Graphic 1: The hierarchy of professional requirements
I, as a professional
need
1. Personal stability
2. Communication skills
3. Specific Early Childhood knowledge
The others (interdisciplinary team) The family
4.2 Communication skills
Especially parents point out that the starting point of the intervention process is decisive, as
they have the feeling that they can “do” something. This aspect is primarily reliant on the
general ability to communicate and a sensitivity towards the family: Parents’ (European
Agency 2004) assess the intervention process in a slightly different way to the professionals
as they assess the whole process as “intervention”.
Graphic 2: ECI process from the parents’ point of view
Graphic 3: Model of an intervention process from the professionals’ point of view
However, the starting point is a fundamental aspect for the parents. Therefore special interest
in professional training requirements concerning the first contact has to be shown (Pretis
2000, 2001). The following criteria for the early stages of ECI are assessed as important from
the parent’s point of view:
- The professional’s interest, especially towards the child (Pretis & Probst 1999)
- Direct contact to the child (bodily contact, naming the child.)
- Time and the ability to listen
- Security and safety in terms of intimacy and data protection
- Transparency concerning the service, procedures and documents
- Avoiding pain or harm to the child
- Competent knowledge and experience
These requirements focus on communication skills, how to communicate with parents. Up
until now only few training programmes (e.g. Pretis 1998b) offer specific modules of
communication and counselling strategies, supported by video feedback of role-playing and
guided communication (using the peer group of the professionals as a pool of resources).
Team work should also be a part of this sensitisation process including
- Reflective observations
- Exchange of hypotheses and theoretical approaches
- Defining goals and strategies
- Defining responsibility (e.g. choosing a key person who is the primary contact person
- Using the team as a resource during the intervention process
- Informing the team members and evaluating the effects
In most European services in-service trainings and supervisions are used for these team-
training processes.
4.3 General knowledge versus specialisation
ECI experts are facing a dilemma: On the one hand they deal with a heterogeneity of family
needs (see table 1) and intervention strategies, on the other hand it is expected from them that
their knowledge of any kind of syndrome (there are more than 3000 defined genetic or
metabolic syndromes) is exact. One can suppose that the ECI professionals – if they have
identified resources and networks with specialists –can be seen more as “generalists” than
specialists, as their model of intervention is a holistic family-centred approach. However, it
may be necessary – concerning teams – to identify specialists for certain questions. The
knowledge of these “team specialists” could be, for example, coordinated by the key person.
Especially concerning specific syndromes (e.g. children with Down’s syndrome, an effect of
specialisation on attributed effects of the intervention could be observed (Pretis 1998a).
The team itself – during processes of profiling or further personal education – could create
such specialised knowledge. However, this process needs to be coordinated, mostly by the
team leaders. Peterander (1997) was able to show that transparency and coordination are two
of the main factors concerning satisfaction in the work of ECI professionals.
5. The European Perspective
The expert group of the European Agency pointed out the following recommendations
concerning training-issues:
Taking into consideration that professionals involved in ECI come from different fields,
therefore, never worked together before, it is essential to reflect upon the type of training they
need to receive in order to be able to co-operate. During the discussions it was highlighted
that the attention should be paid to:
• Initial training: There is a need to share common training aspects for different
professions from different backgrounds, in order for them to complement each
other’s knowledge. Training in aspects such as work with families, teamwork,
child development, etc. should be included in the initial training content devoted to
future health, social and educational professionals. The first requisite for
professionals is to receive a good initial training in their respective fields. Despite
the fact that some specialised knowledge on ECI is always an advantage, it is
hardly the case in any of the countries involved in the project, except in the
Netherlands, Germany, Luxembourg, where special issues on ECI are included in
the initial training addressed to special and social educators, ‘pedagogues’ and
psychologists. The Faculty of Special Education of the Siauliai University in
Lithuania organises a new course on Early Intervention and Pre-school Education
addressed to speech therapists, special educators and physiotherapists.
• Further training: Even if work in the field of ECI is rather complex, there is no
need to create a new type of profession (‘early interventionists’) in order to comply
with the required profile for working in this field. This will go against some of the
key principles in ECI: inter-disciplinarity and teamwork. However, professionals,
working in the field of ECI, need to follow some common further education in
order to build up a common background. This can be achieved through the Masters
courses (as a part of In-Service Training) or specialised training. In Austria, two
universities (Graz and Vienna) and a non-profit organisation based in Salzburg,
organise a one-and-a-half or two years’ course (1440 hours), combining theory and
practical training. A small number of professionals are selected to attend such a
course, designed for qualified professionals with two years of work experience,
interested in working in ECI services. Cost could be partly covered. For those
working in the ECI services, attendance of these courses is a prerequisite in most
of the Austrian Provinces.
In-Service Training (IST): IST is crucial in this field because it helps

compensate the gaps of initial training and meet the needs of the professionals
involved. A distinction needs to be made between ‘informal’/ non-academic
IST and ‘regular’/ academic IST.‘Informal’/ non-academic In-Service Training
is organised in and by the teams, in the frame of weekly meetings, which
allows professionals to:
- organise ‘case discussions’,

- share knowledge and working strategies,
- acquire specific knowledge provided by external professionals,
- discuss management issues internally or with external experts,
- ensure external supervision,
- develop personal competences.
All these elements aim to improve the teamwork and quality of services. Even if this
‘informal’ IST meets the immediate needs of professionals and proves its value, it also
presents some disadvantages. It is often not recognised by the related authorities, in terms of
working time and value, because it mainly focuses on practical daily problems and less on
broad reflections about early childhood objectives, strategies, methods, etc. This might lead to
the situation where the responsibility and initiative are based solely upon the individual teams.
a) ‘Regular’/academic IST is offered in the form of different programmes by universities

or higher education institutions:
- It can take the form of special training courses organised by universities

following the request of ECI centres. This is the case in Munich, where the
programme lasts 12 months. Higher education institutions provide an
intensive Portage course in the Netherlands. In Portugal, similar training is
provided by recognised professionals’ organisations.
- ECI can also be part of a Masters’ Degree on Special Education, which is

the case in the Czech Republic, in Germany (Universities of Cologne,
Dortmund and Munich), in the Netherlands (Gröningen University) and in
Portugal (Lisboa, Aveiro and Coimbra Universities).
- Finally, some countries offer a Masters’ Degree on Early Intervention,

which are all inter-disciplinarily oriented. In Spain, 6 universities
(Barcelona, Madrid, Malaga, Murcia, Santiago de Compostela and
Valencia) organise quite different content-oriented degrees. They are
created for qualified professionals from different fields and last for one to
two years as part-time courses, from 400 to 750 hours. They are not free of
charge and combine theoretical and practical education; neurological
aspects as well as psychology, teamwork and partnership with families are
also generally included.
In Portugal, Porto and Minho Universities offer a two-years Masters’ Degree; with a thesis
required at the end. The general aim is to prepare professionals for work with families and to
use specific tools, such as Portage, elaboration of a Family Support Plan, etc. They are not
free of charge.
In Germany, the Munich University also offers a Masters’ Degree, addressed to different
professionals. The ecologic model is at the centre of this interdisciplinary course. Theoretical
education and practical competences are part of it. It lasts four semesters (120 hours) and it is
free of charge.
An ecologic orientation is also part of the Masters’ programme organised by the Västerås
University in Sweden, which includes: relations within the team, models of early intervention,
work with families, etc. It is free of charge, and lasts for two years, with one year of part-time
theoretical education and the second year of part-time practical education (100 hours).
Similar Masters’ programmes are being organised in Estonia.
Finally, a Transatlantic Consortium on ECI was developed by four European universities and
three from the US. It offered three weeks intensive courses and longer stays for students at the
universities involved. The ecologic and systemic approaches are at the basis of this co-
operative training. An international curriculum in ECI will be developed.
More information on post-graduate courses in different countries is available in the online

web area (www.european-agency.org).
Taking into consideration already existing knowledge in the frame of IST and the expected
work to be undertaken by professionals, IST needs to cover the following areas:
• Basic knowledge: this mainly concerns an in-depth knowledge on

development of very young children, with and without special needs, and
related theoretical background;
• Specialised knowledge: this refers to a recent research in the field of ECI,

assessment, working methods, etc.
• Personal competences: this is a key area, which concerns all aspects related
to foster children working with/ in families; working in a team; co-
operation among services, as well as, inter alia, development of personal
abilities, such as self-reflection, communication skills, problem-solving
strategies.
6 Perspectives
The diversity of ECI concerning organisations, applied models and professional training
approaches in Europe, reflects acknowledgement of historical backgrounds, cultural
sensitivity and openness towards needs for special support of the families. Comparability
seems to be difficult and always may include aspects of “evaluation”. Concerning the issue of
professional training in ECI our perspective consists of a pool of possibilities in terms of
resources, excluding a unification of approaches. Therefore it does not seem our primary goal
to create a new “profession”, like for example in Austria. However, it is important to
elaborate on a new professional awareness of ECI. Comparable professional training
possibilities is one way of achieving this. A current Leonardo da Vinci Project is in the
process of trying to combine individual and national training idiosyncrasies with the idea of a
European pass on professional training. The main idea consists of individual approaches
(based on the individual’s education, e.g. a psychologist, speech therapist, MD, pedagogue,
special educator, occupational therapist, moto-therapist…) and on the three columns of the
specific requirements in the field of ECI: a) Personal pre-requisites and teamwork, b)
Communication skills and c) Specific early childhood knowledge.
Graphics 4: Individual model of comparable ECI professional education
To save costs and time one can suppose that theoretical issues (specific early childhood
knowledge) could be disseminated through techniques of information and communication
technologies in terms of e-learning modules. Communication, teamwork and reflection of
work require personal evaluation and cannot be replaced, because the main factor of learning
within this context is experience and feedback.
There is no need to define whether specific professional education in ECI should be organised
in terms of (external) further or internal in-service training, as this depends on individual or
national preferences. But there is a consensus on the European level that a common approach
towards a specific education in ECI has to somehow be systematised and co-ordinated. In
future parents will more actively ask for the best quality in ECI and it is the right of the child
to grow up in favourable conditions (www.unicef.or.at). For these vulnerable children ECI is
one puzzle to create equal opportunities and ECI – based on qualified professionals – may
partly contribute to reach this goal.
7.References:
European Agency for the Development in Special NeedsEducation (2004) Personal communication within
the validation meeting, 22-24.10.2004 Brussels.
Dunst, C. J.; Snyder, S. W.; Mankinen, M. (1989). Efficacy of early intervention. In: M. C. Wang; M.C.
Reynolds, Walberg (eds.), Handbook of special education. Vol 3, 259-294. Oxford: Pergamon
Guralnick, M. (1997). The effectiveness of Early Intervention. Brokes, Baltimore
Peterander, F. (1997): -- (1997). Wege zu einem qualitätvollen Handeln in der Frühförderung. Vortrag gehalten
am 20.10.1997 auf der Frühfördertagung "Professionalität in der Frühförderung" der Österreichischen
Gesellschaft "Rettet das Kind" in Eisenstadt, Burgenland. (Ways towards working with quality within the
field of Early Intervention, German)
Pretis, M. (1997). Wenn sich Visionen an der Realität messen. Fremd- und Selbstevaluation in der
Sehfrühförderung blinder und sehgeschädigter Kinder. Frühförderung interdisziplinär, 16, 15-23.
[Comparing visions and reality in Early Intervention in visually impaired children, German]
Pretis, M. (1998a). Evaluation interdisziplinärer Frühförderung und Familienbegleitung bei Kindern mit Down-
Syndrom. Bedingungs- und Wirkfaktoren, kovariierende Variablen. Frühförderung interdisziplinär, 17,
49-64.[Evaluation of Early Intervention in Children with Down’s Syndrome, German]
Pretis, M. (1998b). Das Modell "Steiermark". Frühförderung interdisziplinär, 17, 177-183.
[The Styrian/Austrian model of Early Intervention]
Pretis, M. (1999). Krisenintervention in der interdisziplinären Frühförderung und Familienbegleitung.
Frühförderung interdisziplinär, 18, 145-155. [Crisis Intervention in Early Intervention, German]
Pretis, M. (1999). Zwischen Lust und Frust: Erlebter Therapiedruck in der Frühförderung. Frühförderung
interdisziplinär, 18, 109-116.[Delightment frustration and expactations in Early Intervention, German ]
Pretis, M. (2000). From Evaluation to Methodology. Early intervention in children with Down's syndrome.
Children and young infants. 23-31
Pretis, M. (2001). Frühförderung planen, durchführen und evaluieren. München: Reinhardt. (Planing,
performing and evaluation early childhood intervention, German)
Pretis, M., Dimova, A. (2004). Frühförderung bei Kindern psychisch kranker Eltern. München: Reinhardt.
(Early intervention in children of parents with mental disorders, German)
Pretis, M. (2004)-. A Developmental Communications Model Within the Early Intervention System in Austria.
In: M. Guraclnick: Early Intervention over the world. II. Baltimore: Brooks (in press).
Schlack, H. G. (1991). Die Auswirkung der Frühbehandlung des behinderten Kindes auf seine Familie.
Frühförderung interdisziplinär, 10, 37-41. (The effects of early childhood intervention for the child with
disability and the family, German)
Sheehan H., Snyder S., Sheehan, R. (2004): Qualitätsmanagement in sozialen Einrichtungen in den USA. In:
F. Peterander, O. Speck (eds), Qualitätsmanagement in sozialen Einrichtungen,114-129. München:
Reinhardt
Shonkoff, J.P.; Hauser-Cram, P., WyngaardenKrauss, M.; Christoph-Upshur, C. (1992). Development of
infants with disabilities and their families, implication for theory and service delivery. Monographs of the
Society for Research in Child Deveolpment 57.
Speck, O. (2000) Vortrag im Rahmen des Münchener Symposions "Kompetenz und kreativ in die Zukunft", 6-
7-4.2000 München. (Competence and creativity for the future, German)
Weiss, H.; Neuhäuser, G.; Sohns, A. (2004): Soziale Arbeit in der Frühförderung und Sozialpädiatrie.Weinheim:
Beltz. (Social work in the field of Early Childhood intervention and social pediatry, German)
www.eqm-pd.com (29.10.2004)
www.unicef.or.at (31.1.2004)
View publication stats

Professional Education in Early Intervention Syste

Caricato da

Informazioni sul documento

Titolo originale

Copyright

Formati disponibili

Condividi questo documento

Condividi o incorpora il documento

Opzioni di condivisione

Hai trovato utile questo documento?

Questo contenuto è inappropriato?

Copyright:

Formati disponibili

Professional Education in Early Intervention Syste

Caricato da

Copyright:

Formati disponibili

See discussions, stats, and author profiles for this publication at: https://www.researchgate.

Professional Education in Early Intervention Systems in Europe An overview

Article · January 2005

Acute response to stress: extended version of sequance order View project

It is case report View project

The user has requested enhancement of the downloaded file.

Aleksandra DIMOVA (PhD)

Graz, January 2005

1. The focus on the issue of professional training

1.1 An example of the professional reality

1.2 An overview of the training situation

2. The situation within the European Member states

4. The requirements for professional education

4.1General personal requirements including working in teams

4.2 Communication skills

4.3 General knowledge versus specialisation

5. The European Perspective

1. The focus on the issue of professional training

a) That the implementation of ECI-systems in European countries seems to be finalised:

1.1 An example of the professional reality

Table 1: Timetable of an ECI professional based on an Austrian situation

17.00-17.30 Reflection and documentation of the

1.2 An overview of the training situation

To mention some initiatives:

- discussion of a curriculum for professionals in Germany (VIFF 2005)

Country Involved professionals Specificity of Organisation of Comment

2. The situation within the European Member states

Health care/hospitals, Local and Medical doctor – 6 years university studies

Kindergarten – special 2 years – Education Local community administration;

Centres/Names Number Age Responsibility Training issues

Centres/Names Number Age Responsibility Comments Training issues

Organisation Age Responsibility Comments Training

Precocious Medico- 0-6 Detection and prevention,

Country number Age Responsibility Comments Training

Centres/ Names Number Age Responsibility Comments Training issues

Centres/ Names Number Age Responsibility Comments Training issues

School for impairment/ 1 From Ministry of Education

Some of the centre are

4. The requirements for professional education

4.1General personal requirements including working in teams

Graphic 1: The hierarchy of professional requirements

The others (interdisciplinary team) The family

4.2 Communication skills

Graphic 3: Model of an intervention process from the professionals’ point of view

4.3 General knowledge versus specialisation

5. The European Perspective

In-Service Training (IST): IST is crucial in this field because it helps

- organise ‘case discussions’,

a) ‘Regular’/academic IST is offered in the form of different programmes by universities

- It can take the form of special training courses organised by universities

- ECI can also be part of a Masters’ Degree on Special Education, which is

- Finally, some countries offer a Masters’ Degree on Early Intervention,

Similar Masters’ programmes are being organised in Estonia.

More information on post-graduate courses in different countries is available in the online

• Basic knowledge: this mainly concerns an in-depth knowledge on

• Specialised knowledge: this refers to a recent research in the field of ECI,

Graphics 4: Individual model of comparable ECI professional education

View publication stats

Potrebbero piacerti anche