Early Intervention Therapy for Children With Delayed Development: Enabling Access in India's Rural Communities
Early Intervention Therapy for Children With Delayed Development: Enabling Access in India's Rural Communities
This study is a cohort longitudinal design, also known as within subject repeated measures'
 design to measure the impact of an early identification and intervention program being
 implemented by Amar Seva Sangam (ASSA), an Indian non-government organization in South India.
 The primary objective of the Early Intervention (EI) Village-Based Rehabilitation (VBR)
 program is to increase access to early identification and early intervention therapy to
 enhance physical, cognitive, language, social and emotional development of children with
 developmental delays. The primary outcome will be the creation of developmental trajectory of
 girls and boys with developmental delay who are receiving village based early intervention
 therapy in rural India, aged 0 - 6 years based on the Gross Motor Function Measure - GMFM
 (children with cerebral palsy only), Functional Independence Measure - wee-FIM, Functional
 Assessment Checklist for Programming - FACP, Communication Developmental Eclectic Approach to
 Language Learning - CDDC and Canadian Occupational Performance Measure - COPM. Secondary
 outcomes will be the effect of therapy compliance rates on development in girls and boys with
 developmental delay, the effect of therapeutic approach on development in girls and boys with
 developmental delay, improved enrolment in school for children with developmental delays from
 age 3 to 6; and, improved parent/caregiver knowledge, attitude, behavior and confidence in
 caring for their child with developmental delay.
This study is a cohort longitudinal design, also known as within subject repeated measures'
 design to measure the impact of an early identification and intervention program being
 implemented by Amar Seva Sangam (ASSA), an Indian non-government organization in South India.
 The primary objective of the Early Intervention (EI) Village-Based Rehabilitation (VBR)
 program is to increase access to early identification and early intervention therapy to
 enhance physical, cognitive, language, social and emotional development of children with
 developmental delays. The primary outcome will be the creation of developmental trajectory of
 girls and boys with developmental delay who are receiving village based early intervention
 therapy in rural India, aged 0 - 6 years based on the Gross Motor Function Measure - GMFM
 (children with cerebral palsy only), Functional Independence Measure - wee-FIM, Functional
 Assessment Checklist for Programming - FACP, Communication Developmental Eclectic Approach to
 Language Learning - CDDC and Canadian Occupational Performance Measure - COPM. Secondary
 outcomes will be the effect of therapy compliance rates on development in girls and boys with
 developmental delay, the effect of therapeutic approach on development in girls and boys with
 developmental delay, improved enrolment in school for children with developmental delays from
 age 3 to 6; and, improved parent/caregiver knowledge, attitude, behavior and confidence in
 caring for their child with developmental delay.

 For each child with a developmental delay who is enrolled in the early intervention program,
 a detailed care plan will be developed by the rehabilitation professional(s) who will provide
 the care based on the specific needs of the child. A trained community rehabilitation worker
 (CRW) will implement the care plan with a focus on the one or more domains where delays were
 identified (i.e. speech, motor, cognition). The intervention will be delivered either within
 the child's home (home based rehabilitation) or at an local Early Intervention Parent
 Participation Centre (EI PPCs) (centre based care). Each child will receive a minimum of one
 therapy session per week by the CRW and a monthly therapist visit (i.e., physical therapist,
 occupational therapist, special educator and/or speech therapist) for home based care. In
 center based care daily therapy will be available by either a CRW or specialist. In addition,
 monthly team meetings will be held by the specialists and CRWs to monitor progress and modify
 or adapt therapy plans as needed. Therapy will be tailored based on the needs of the
 individual child and will follow current evidence-based practice. The investigators will do
 evaluations using the standardized scales noted above (GMFM, WEE FIM, COPM, FACP and COM
 DEALL) every 6 months to monitor the progress of the child.
Inclusion Criteria:

 -  Boys and girls

 -  Newborn to age 6

 -  Identified with developmental delay based on the Trivandrum screening tool

 -  Diagnosed as definitive delayed development by a team of rehabilitation specialists
 (i.e. physical therapist, occupational therapist, speech therapist, special educator)

 -  Receiving either home-based or center-based care in the ASSA Village-Based Early
 Intervention Program

 -  Live in one of the following 7 blocks in the District of Tirunelveli: Alangulam Block;
 Kadayanallur Block; Keelapavoor Block; Shenkottai Block; Tenkasi Block; Sankarankoil
 Block; and, Vasudevanallur Block

 Exclusion Criteria:

 -  None