Early Care: Resources and Opportunities for Psychological and Pedagogical Support for a Child and his Family in the Yaroslavl Region

Introduction

Along with the increase in the child population in the Russian Federation, there is a rapid growth in the number of children with health problems of various etiologies and severity, children with risks of developmental disorders [7; 8; 9]. The effectiveness of the comprehensive psychological and pedagogical support for young children is largely determined and depends on the timely detection of disorders, the creation of special conditions to activate their cognitive abilities, the use of methods for the early detection and correction of deviations in child development, systematic medication support, and family involvement in early childhood support. Due to this, more and more attention is being paid to the development of a national system of early childhood intervention for children from birth to three years of age and their families.

Methods

The monitoring of early intervention in educational organizations of the Yaroslavl Region is carried out annually from 2020 in accordance with the forms developed by the Ministry of Labor and Social Protection of the Russian Federation together with the Federal Scientific and Educational Center of Medical and Social Expertise and Rehabilitation named after G.A. Albrecht. During the course of the 2023 monitoring, data on the total number of children from birth to 3 years of age who underwent a comprehensive examination in psychological, medical and pedagogical commissions, as well as children who are in need of and received early intervention services in 140 basic educational organizations (early intervention services) in municipal districts of Yaroslavl Region were analyzed.

The questionnaire survey involved 140 teachers of the specialists involved in the psychological and pedagogical support of young children and their families, and 956 families with young children living in Yaroslavl Region. There are 697 families (73%) in urban areas, 259 families (27%) in rural areas, 795 nuclear families (83%), 161 single-parent families (17%). The parents’ age ranged from 23 to 37 years. The data on the nosological representation of children of the target group, the possibilities of the psychological and pedagogical support for young children and their parents (legal representatives) were systematized, and the staffing of basic organizations providing early intervention services was analyzed. 

Results and Discussion

Needs of families with young children in early intervention activities In the Yaroslavl Region, comprehensive psychological, medical and pedagogical support to children with developmental disorders, including in early childhood, is provided in state general education institutions, health care institutions, counseling centers, municipal preschools, centers for psychological, pedagogical, medical and social support, as well as centers for additional education and autonomous non-profit organizations.

Early intervention services have been established on the basis of preschools and have been functioning for many years. It is fundamentally important to ensure the maximal territorial accessibility of psychological, medical and pedagogical services, the professional readiness of specialists to detection deviations in child development early and to conduct corrective and developmental work, as well as the organization of this activity on the basis of interdepartmental and interdisciplinary cooperation, the timely provision of early psychological, medical and pedagogical support and the family-centered nature of activity [15]. The coordination of activities for the development of the early intervention system in the region is carried out by the Yaroslavl Region “Children’s Assistance Center”.

The number of early intervention services in the period from 2020 to 2023 changed, taking into account the appeals of parents (legal representatives), human and material and technical resources, regional conditions: in 2020 — 182 organizations; in 2021 — 116 organizations; in 2022 — 144 organizations; in 2023 — 140 organizations.

The early identification of children with developmental disorders is one of the priority areas in the work of specialists; support is provided on a declarative principle, both directly when parents (legal representatives) apply to early intervention services and in the central and territorial psychological, medical and pedagogical commissions of the Yaroslavl Region (PMPC). The increase in recent years in the number of applications to the PMPC and in the number of children who have undergone a comprehensive psychological, medical and pedagogical examination testifies to the early identification by specialists of children with developmental disorders in preschools. According to PMPC data, in 2023, 2,598 children from birth to three years of age underwent a comprehensive examination, which is 24% more than the number of children examined in 2022 (mostly from one and a half to three years of age): 1,615 children in 2018, 1,803 children in 2019, 2,024 children in 2020, 2,102 children in 2021 and 1,997 children in 2022. Approximately 75% of young children whose parents participated in the monitoring need upbringing and education under adapted educational programs of preschool education. 25% of families with children at risk of developmental disorders are referred to early intervention services in the region.

Number of children who received early intervention services in 2023

According to the data of the form “On the submission of the federal statistical report 1— RP”, in 2023 early intervention was provided to 1174 children and their families. The total number of children who received early intervention in 2023, compared to 2022, decreased by 5% (in 2022, early intervention was provided to 1,235 children of the target group), which is obviously due to a slight decrease in the birth rate in the Yaroslavl Region. The largest number of children who received early intervention services in the Yaroslavl Region in 2023 live in Rybinsk (345 children), Yaroslavl (211 children), Uglichsky District (91 children), Tutaevsky District (86 children) and Pereslavl-Zalessky (58 children).

It is noteworthy that in some municipal districts of the region the number of young children as recipients of services is insignificant (Nekrasovsky, Nekouzsky, GavrilovYamsky districts), and, in some districts of the region, no support was provided to young children in 2023 (Bolsheselsky, Lyubimsky, Breitovsky). It becomes obvious that not all districts of the YR are working to provide children with early psychological and pedagogical support in a timely manner. Presumably, the low demand for early intervention services in these municipal districts is associated with an insufficient awareness of the population about the possibility of receiving such services. As the reasons for this, the heads of educational authorities in the districts name a decrease in the total birth rate and, as a consequence, a decrease in the number of families in need of early intervention. Informing the population about the possibilities of receiving early care and the timely identification of children at risk of developmental disorders and their further comprehensive support in a number of municipal districts of the region is hampered, among other things, by insufficient interdepartmental cooperation between organizations providing early intervention services. The monitoring results show that the specifics of the disorders of psychophysical development of children with disabilities in 2023 are extremely heterogeneous.

The total number of young children with disabilities in the YR is 2,337 (in 2022 — 1,878 children) (see table).

The results show that not only children with disabilities and children with delayed speech development, but also children at risk of developing disorders and children with the deficit in the development of certain cognitive functions and the delayed psycho-speech development need comprehensive early intervention. The most numerous in 2023 is the group of children with delayed speech development (1,612 children), delayed mental development (295 children), visual impairments (visually impaired — 174 children) and musculoskeletal disorders (218 children). 

Numerical Data on Young Children with Psychophysical Developmental Disorders Examined in PMPC in 2022, 2023

Table 

Note that compared to the data of 2022, in 2023 there is a significant increase in the number of children with a temporal delay in speech development (by 27%), which may be due, firstly, to the fact that the system of the early identification of children with developmental disorders is actively developing, and support specialists send children with disabilities to the PMPC in a timely manner to address the issue of their further upbringing and education. Secondly, the lack of phrasal speech as a means of communication in children in the third year of life is one of the most noticeable and obvious signs of a problem in child development for parents, which suggests visiting a specialist [6].

The monitoring revealed that the categories of children with hearing loss and autism spectrum disorders (6 and 8 children respectively), with intellectual disabilities (24 children) are very few in number, which is probably due to the difficulties in providing support to children with these nosologies, as well as to the lack of parents’ requests for early intervention services. The results of the All-Russian monitoring of the state of education of students with autism spectrum disorders confirm the trend identified in the YR [17]. There is a foreign study of the difficulties in the differential diagnosis of children with autism spectrum disorders [28].

According to the results of examination at the PMPC, 261 young children with an intact intelligence but with risks of developmental disorders were identified. This category of children needs psychological and pedagogical support (10% of the total number of young children examined in PMPC YR). In 2023, the number of applications to PMPC of parents with children with an intact intelligence and at risk of developmental disorders increased by 58%, compared to 2022, which is probably due to informing parents about the possibilities of psychological and pedagogical support for children.

Families with children of the second and third year of life predominantly apply to organizations for early intervention services (see Fig.). There are very few infants represented. This may be due to the fact that the primary support for this category of children is provided in health care organizations, and pediatricians do not detect any disorders in the neuropsychological development in children during the first year of life. The increase in visits to early intervention services for children in the second and third years of life is, firstly, due to the beginning of kindergarten attendance and a clearer identification of the markers of impaired development by specialists in the education system (teachers-defectologists, educational psychologists, speech therapists), and, secondly, to the vivid manifestation of the existing signs of disadvantage in child development in children at this age.

In the municipal districts of the Yaroslavl Oblast and urban districts in 2023, early intervention was provided to the following categories of children:

1.   Children with disabilities — 83 children, 7.5% of the total number of those who applied (61 children in 2022);

2.    Children with genetic disorders — 18 children, 1.5% (in 2022 — 17 children);

3.    Children at risk of developmental disorders — 1073 children, 91% (in 2022 — 1157 children), including:

—  children with disabilities, at risk of developing persistent disorders of body functions and limited life activity (936 children);

—   orphans and children left without parental care (not with disabilities) (11 children);

—  children from families at risk (not with disabilities) (126 children).

Fig. Number and age of children who received early intervention services in the Yaroslavl Region in 2022 and 2023

In 2023, a questionnaire survey of families with young children was conducted on the topic of the need for early intervention services, in which families who received services participated.

The percentage of families in Yaroslavl Region who participated in the survey and received early intervention services in 2023 was 82% (81% in 2022). According to the results of the survey, in 2023, support was provided to 956 families with 966 young children).

According to the questionnaire data:

—  the share of families in need of early intervention services that are covered by services in Yaroslavl Region is 92.49% (in 2022 — 91%);

—   the share of families in the Yaroslavl Region included in early intervention programs and satisfied with the quality of services is 95.30% (82% in 2022);

—  the share of children who received early intervention services in the total number of children in the target group in the Yaroslavl Region who need such services — 91.42% (92% in 2022)

The majority of children in the target group (99%) need early intervention services. Qualified support is provided in preschools in groups of compensatory and combined orientation if there are specialists in these institutions.

Specialists note that in a number of cases they experience difficulties in providing support to young children of various nosological groups. Work with the parents (legal representatives) of children with sensory impairments and multiple severe developmental disorders is particularly difficult. Support is mainly provided to children from 1 year 6 months to 3 years of age. Infants are practically not covered by counseling support [12].

Provision of early intervention activities with human resources

Analyzing the staffing in the early intervention system of the region, we note that 460 specialists of different 

profiles are included in the system of the comprehensive psychological, medical and pedagogical support of young children. These are 72 heads of early intervention services, 130 educational psychologists, 68 teachers-defectologists, 170 teachers-speech therapists, 7 physical education instructors, 9 social pedagogues, 4 pediatricians.

Compared to previous years, the number of specialists working in the early care system has decreased (490 in 2022, 395 in 2021 and 282 in 2020).

The early intervention services are best provided with specialists who provide psychological (93%) and speech therapy (100%) support for children. Pedagogical support for young children by teachers-defectologists is not fully represented (49%).

Psychological and pedagogical support for young children and their families

It should be noted that the region has organized work on psychological and pedagogical support in accordance with the individual rehabilitation or habilitation program for young children with disabilities on the basis of the Agreement on Information Interaction dated 10.05.2023 No. 59/70/23 between the Department of Education of the Yaroslavl Region and the Department of Labor and Social Support of the Population of the Yaroslavl Region using a unified system of interdepartmental electronic interaction. Infants and young children at risk of developmental disorders, as well as children of the second and third years of life who do not attend preschools, are not fully covered by pedagogical support. One of the reasons is the weak interdepartmental information interaction between the education, health care and social protection systems, as well as the failure to include these children in a single electronic system.

In the process of the psychological and pedagogical support of young children and their parents (legal representatives), specialists of early intervention services of the YR provide counseling support, carry out the necessary corrective, developmental and rehabilitation work, taking into account the psychophysical characteristics of children. In 2023:

—   788 parents were provided with counseling support with the subsequent creating of an individual early intervention program for a certain period (in 2022 — to parents of 934 children);

—   178 parents were provided with counseling support without the subsequent creating of an individual program of early intervention (in 2022 — to the parents of 82 children).

Various forms of work are used: individual and group classes, counseling, distance support of families, etc. In 2023, 1,283 events with young children and their parents were held (in 2022 — 1,421 events). The decrease in the number of individual events in the region as a whole is due to the fact that specialists working with young children actively use group forms of work with a fairly wide coverage of children in this category.

Types and forms of psychological and pedagogical support for young children and their families When providing support to a child at risk of developmental disorders, face-to-face and distance forms are more in demand. At the stage of primary face-to-face counseling, an in-depth assessment of the child’s psychophysical state is conducted, the basic needs of the child and his or her family are identified, and further corrective and developmental work with the child is planned. Distance counseling is conducted in video and audio modes in the form of synchronous and asynchronous correspondence using various messengers. Training activities, the application of the supervision method and increasing the efficiency of the professional activity of specialists, taking into account individual psychophysical characteristics of young children, as well as macro— and microfamily conditions partially prevent negative components of the counseling process in the distance format. Practice has shown that the most effective in working with a young child and his or her family is a combination of face-to-face and distance formats. Thanks to the distanced provision of counseling services, the availability of early intervention for families living in remote areas of the region has been ensured.

Individual and group sessions with young children are important for parents. Conducting individual sessions on the basis of the program of early intervention to a child and his family is more appropriate for children with sensory, intellectual and multiple severe developmental disorders. Group forms of work are applicable to the category of children at risk of developmental disorders, with the deficit in the development of certain cognitive functions.

In parent-child groups (children from one and a half to three years old), each session is combined, consists of several stages and involves a sequential transition from one type of activity to another. The loads are dosed with taking into account the individual and psychophysical characteristics of each child [14].

In the work on the development of attention, memory, sensorimotor skills, speech in the form of free play and use individually selected toys and methods. In the method of prelinguistic environment, training in motivated interaction with the child uses non-verbal and verbal means of communication, the organization of the environment to involve the child in joint activity with an adult, orienting and emotionally charged support, taking into account the individual characteristics of the child and his resource capabilities [2; 27].

Sessions in the conditions of parent-child groups involve mandatory training practice-oriented seminars for parents on the basics of early childhood psychology, as well as practical exercises to improve the interaction between the parent and the child, teaching the correct approaches to development and upbringing. The classes improve the emotional interaction between children and their parents.

According to A.M. Kazmin’s research, it is preferable to conduct early childhood support in natural life situations in which social and emotional, executive, universal, and complex competencies are formed [25]. The need to assess and form motor skills, cognitive and conversational competencies in young children is also emphasized in foreign studies [18; 23; 26].

Socio-pedagogical and socio-psychological support to the child and his/her family is implemented by specialists of educational organizations of the YR within the framework of home visitation technology, teaching parents how to care for the child, methods of his/her development and upbringing at home. During the visit, professional observation and the analysis of behavioral manifestations of a close adult in the interaction with the child, affecting the development of emotional and cognitive processes [19]. In practice, this type of support is not fully implemented and is not demanded by parents. Low parental demand for such a service as home visitation and its insufficient implementation in the region can be explained by the reluctance and unwillingness of parents (legal representatives) to allow a specialist into the family environment (the reasons are different: the state of stress at the birth of a child with developmental disorders, the low social status of the family, employment in domestic situations in a large family, etc.).

Conclusions