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ECI in the Community for Preschool Children and their Families 

Theotokos Foundation's submission 'ECI in the Community' was chosen as one of the three promising practices within the 'Early Childhood Intervention' category. The programme operates in 20 nursery daycare centres, and its principal aim is the early detection and intervention of children who are at risk of developmental delay or emotional difficulties. 

Name of practice: Early Childhood Intervention (ECI) In the Community for Preschool Children and their Families 

OrganisationTheotokos Foundation 

Description of organisation: "THEOTOKOS" Foundation is a non-profit welfare organization (private law entity) and has been operating continuously since 1963. Special education and therapy services are provided to preschool children (early intervention) and to teenagers with developmental delays, developmental intellectual disorders and autism spectrum disorders. Vocational training and rehabilitation are provided to young adults. Family environments are supported and intervention is implemented when necessary.

Country: Athens, Greece 

Year of Initiation: 2016 

Funding: Funded mainly through the Theotokos Foundation’s own funds 

Link to UNCRPD: Article 7 – Children with disabilities, Article 23 – Respect for home and the family, Article 25 – Health 

Description of practice: ‘ECI in the Community’ is a programme operating across 20 nursery day-care centres targeted for children, aged between 1,5-4 years old, and their families. Organised in cooperation with the Theotokos Foundation and the neighbouring municipalities, its principal aim is the early detection and intervention of children who are at risk of developmental delay or emotional difficulties. Effective early intervention works to ensure the healthy development of the child, empower their families, support teachers, achieve social and school inclusion and promote deinstitutionalisation.  

Problem Targeted: In Greece, the referral process of ECI services largely relies on parents taking the initiative when concerned about their child’s general development. This process is limited in its capacity and has significant economic implications, as the cost of therapy programmes is high and is covered mainly by families. Moreover, the ECI process is not legislated yet in Greece, meaning little awareness-raising is done on the early identification of difficulties. It is therefore necessary for such ECI processes to focus on the prevention of developmental, emotional, and psycho-social difficulties, to implement early detection activities with practical evidence-based tools and to establish procedures ensuring a timely referral.

Solution offered: The practice is a synergy and collaboration between the interdisciplinary team of Theotokos, the staff of day-care centres and the parents. What is innovative about this programme is its focus on prevention rather than crisis and the provision of methods for early detection and intevention. 

These ECI services are made available as geographically close as possible to the families and are cost-free.  The service has further provided the necessary screening and assessment tools (which address multiple developmental domains) that will help specialists, healthcare support teams, staff of nursery day centres and parents to identify difficulties as early as possible and seek access to ECI services. 

The programme employs specific methodology that has been evolved throughout the years and standardized tools. Tools include Griffith’s III Developmental Scale, Achenbach Child Behaviour Checklist (standardized in the Greek population), Denver Developmental Screening Test, AnOmiLo 4 (Speech and Language Screening) and questionnaires such as M-chat and Speech and Language Development questionnaire (developed by SLT Department of Theotokos).

Furthermore, through the use of comprehensive and interdisciplinary assessments, along with classroom observations, teacher’s verbal reports and parent’s concerns and priorities, Theotokos can create effective Individual Child and Family Service Plans.   

The methodology employed is made up of six phases: 

  1. Raising awareness on the importance of prevention and the usefulness of the programme. 
  2. Conducting screenings at nursery day centres. 
  3. Performing assessments of children that have been identified as being at risk of developmental delay or emotional difficulties. 
  4. Consultation with parents 
  5. Referral for further assessment/diagnosis of children that have been identified as having difficulties in more than one developmental area or present signs of emotional difficulties.  
  6. Providing individualised intervention for children and their families through the help of an interdisciplinary team.  

Impact generated by practice: Within the past 6 years, the Theotokos Foundation has assessed over 1600 children, from which 15% showed difficulties. Children that have been detected and assessed with difficulties have either been referred to public services for diagnosis and intervention or they were provided intervention at EIP of Theotokos Foundation.   

Theotokos has managed to build a strong, collaborative relationship between parents, teachers and the children based on trust and the empowerment of families and educational staff. ECi in the Community has helped offer group training to parents and nursery day centre teachers, regarding developmental issues and has supported teachers in dealing with difficult situations in the classroom. Improving the abilities of all stakeholders will allow for more timely intervention and as a result, stronger social inclusion of children. 

Sustainability of Practice:  Over time, the programme can be scaled up by creating a guide on the prevention and early detection for professional health care and support staff. The guide will have the flexibility of being used by any professional that supports educational staff and/or is responsible for the supervision of children in day-care nurseries, therefore broadening the number of children that can undergo screening and assessment. 

Contact information: Mirella Giannakopoulou, Head of Early Intervention Department: mgiannakopoulou@theotokos.gr