Early intervention for premature born children

Transkript

1 Early intervention for premature born children A project in cooperation with : - Sørlandet hospital in Kristiansand - Sørlandet Resource Centre. - The parents organization for premature children - With economic support from the norwegian organization Health and Rehabilitation

2 The fundamental idea Early intervention Interdisciplinary cooperation Preventative support

3 Professionals Nurse Paediatricion Physiotherapist Special needs educator Psycologist

4 Intervention group and control group Randomized into two groups Interventiongroup: test and homevisiting Control group: test

5 Our project includes: Infants with a birthweight of 1500 grams and less and/or Born before 30 weeks of pregnancy Citizen in East or West-Agder county Triplets are not included in our project.

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8 Research on the long terms effect of prematurity : Increased risk for effects within : - Language - Mental health - Motor skills

9 Organizing the intervention 1st. year: Homevising once a month 2nd. and 3rd. year: Homevisiting every second month Being together with the family and combining knowledge with daily activities

10 The programme we use in the intervention group Norwegian version Original version in English

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12 Core values of the Growing: Birth to three. Relationship based Ecological approach Family centered Strength based Reflective strategies

13 Core values 1. Parent child interactions are the heart of early intervention. 2. The intervention prosess begins with the parents rather than the child. 3. Family rituales, play and daily routines are the medium into which intervention is embedded. 4. The intervention is guided by the family and the prosess is sensitive to family diversity, including ethnic and cultural dimensions.

14 Components of Growing Birth to three. - Piecing It All Together - Development Guide - Interactions and Dayly Routines - Nurturing journal 1 and 2. - (Building and sustaining relationships)

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17 The Development Guide. 11 sections: A. I ve arrived. Are you ready? B. I m hungry. C. Using my senses. D. I m cathing on. E. Understanding my world. F. Finding my voice. G. Who s in charge? H. I m getting organized. I. I d rather do it myself. J. On the move. K. Using my hands.

18 B. I m hungry.

19 C. Using my senses.

20 D. I m cathing on. Titt-titt i speilet. Jeg ser mamma i speilet. Nese, munn og ører ser jeg lett. Jeg så dama der også (D18).

21 E. Understanding my world. Lua er altfor stor til hunden! (E 25).

22 F. Finding my voice.

23 G. Who s in charge. Sånn kan du klikke på pennen, sier mamma.

24 H. I m getting organized. Pus vil også gjerne ha trommestikka. (H 18: Kombinere to gjenstander i leken. ).

25 I. I d rather do it myself. Da vi kom inn sparket hun selv av seg støvlene. Hun kan og vil selv klare ting på egenhånd (I 25)!

26 K. Using my hands. Å bygge klossetårn er lett som ingen ting. (K 28).

27 Small steps. 0-6 months

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29 Growing Birth to Three Supports a need for individual, adjusted intervention. Homevisiting gives us this opportunity.

30 A support to the family

31 Parents are the most important for their child Support on the families own conditions We show modesty in the way we meet parents. It is important to have knowledge about the criticle period of time in hospital.

32 Early start, unprepared parents

33 The strain on parents

34 The situation is changing from one day to another

35 One of our objectives is to help parents feel secure.

36 The intervention supports good interactions and communication between parents and child.

37 Meaningful activities Playing with toys often specifies our intentions and brings forward knowledge that we share with the parents

38 The project provides us with knowledge about: The families and their needs The preamature children

39 Gjennom intervensjonsarbeidet Ønsker vi å gjøre foreldrene trygge Ved styrke samspillet Gjøre foreldrene oppmerksomme på fremskritt og den neste utviklingssone. Forslag og ideer til aktiviteter, men først og fremst vektlegge foreldrenes egne forslag.

40 Reports After every home visit we write a report where we focus on the child s skills and possibilities and good social interactions between child and parents. We use photos We save good moments

41 Reports with references to items in the child s Development Guide. The reports are written from the child s perspective: I have become really good at. Using my hands. Small muscle development Jeg er blitt veldig flink til å tegne. Jeg tegner både sirkulære kruseduller og små prikker. Her prøver jeg å etterligne en linje som går vannrett og en linje som går loddrett. Og se hvor fint jeg holder blyanten. Det er jo akkurat som de voksne gjør det. Og det er det bestefar som har lært meg. (K26).

42 Continuing: Using my hands No problem for me to build a tower of 5 or 6 blocks. Here I get to practice aligning. This requires good eye - hand coordination and perfect timing so I let go just at the right moment. (K28). Here you can see Arlene has helped me a little so all the blocks have been used. I can barely wait until she tells me to give it a push.

43 I m getting organized. Function, time, classification. I dag prøvde jeg puttekasse. Det var ikke noe problem for meg å finne ut hvor de forskjellige figurene skulle puttes. (H 19). Og her er mamma også veldig interessert. Dette var gøy!jeg kan også matche former og størrelser. Her ser jeg hvor trekanten, rundingen og firkanten passer. (H 20).

44 Understanding my world. Receptive language/ Attention/ Cognition Jeg er veldig flink til å leke og kan leke selvstendig en god stund alene uten hjelp og rettledning fra en voksen. (E 23). Jeg er blitt veldig glad i rollelek. Jeg kan finne og matche ting som er like. (E24) Her matcher jeg bilder på et Lotto-brett. Ikke lenge før vi kan begynne å spille nå.

45 Continuing: Understanding my world I dag fortalte Arlene et eventyr: Bukkene Bruse med figurer. Det var morsomt. Jeg har god oppmerksomhet og kan lytte en god stund. Jo mer jeg forstår, jo mer vil lengden på oppmerksomheten øke. Jeg forteller litt og så forteller mamma resten.

46 Experiences so far from our intervention. The parents are pleased. Good evaluations from Sørlandet hospital which we cooperate with. Parents feel more secure about the situation. The focus is turned from difficulties that can occur to the child s development and progress. Parents have a positive attitude towards the future. Some families would have wanted the project to continue on to school.