District Early Intervention Centre (DEIC)
A noble concept for Early Childhood Intervention – DEIC
“It’s not a drug, it’s not a vaccine and it’s not a device. It is a group of therapist working together, solving problems and enhancing capabilities
Introduction & Background:
The Ministry of Health and Family Welfare in February 2013 launched the Rashtriya Bal SwasthyaKaryakram (RBSK) for ‘Child Health Screening and Early Intervention Services under National Health Mission. It is a systematic approach to early identification of 4Ds, Defects at birth, Diseases, Deficiencies and Developmental delays to prevent or limit Disabilities in children 0 to 18. Rashtriya Bal SwasthyaKaryakram is an innovative scheme to provide expert screening, early treatment and care for 30 common health problems in children below 18 years of age. Comprehensive Child Health screening and management as a public health approach assures a package of health services for all children from birth to 18 years of age under this initiative.
Rationale behind DEIC:
The idea behind early intervention is to intervene early and minimize disability. Once the disability is already established then the intervention would include enhancement of child development for the child to reach the highest potential for the child possible and prevent progression to handicap that may arise from activity limitation.
Medical/ Therapy Services available in DEICs:
- Medical services – (Doctor: Pediatrician/ Medical officer)
- for diagnostic or evaluation purposes. Medical treatment of children suffering from diseases and deficiencies.
- health-related services necessary to enable a child to benefit from other early intervention services.
- Dental services – (Dentist)
- for problems of teeth, gums and oral hygiene in children from birth to 6 years esp. “Early Childhood Caries”
- Occupational therapy & Physical therapy – Physiotherapist
- services that relate to self-help skills, adaptive behavior and play, sensory, motor, and postural development i.e. services to prevent or lessen movement’s difficulties and related functional problems. Sensory Integration, oro-motor and feeding difficulties.
- Psychological services – Rehabilitation Psychologist/Clinical Psychologist
- administering and interpreting psychological tests and evaluation of a child’s behavior related to development, learning and mental health as well as planning services including counseling, consultation, parent training, behavior modification and knowledge of appropriate education programs.
- Cognition services – identifying cognitive delays and providing intervention to enhance cognitive development, adaptive and learning behaviors.
- Social support services – preparing an assessment of the social and emotional strengths and needs of a child and family, and providing individual or group services such as counseling. Socio economic evaluation of the family and linkages with the need based social services.
- Audiologist cum speech and language pathologist
- Audiology – identifying and providing services for children with hearing loss among children from birth to 6 years for both congenital deafness and also acquired deafness.
- Speech-language pathology – services for children with delay in communication skills or with motor skills such as weakness of muscles around the mouth or swallowing.
- Vision services – Optometrist
- Identification of children with visual disorders or delays and providing services and training to those children.
- Retinopathy of Prematurity (RoP) – for premature or preterm children.
- CVI – Specialized Dark rooms and Therapy services for cerebral visual stimulation
- Lab services – Lab technician
- for routine blood investigations among children to begin with but slowly would develop services for confirming congenital hypothyroidism, Thalassemia and Sickle cell anemia or other inborn error of metabolism depending on the prevalence of such diseases.
- Nutrition services – Nutritionist/ Dietician or Nursing staff
- services that help address the nutritional needs of children that include identifying feeding skills, feeding problems, food habits, and food preferences.
- Psycho-social services – Special Educator
- includes designing learning environments and activities that promote the child’s development, providing families with information, skills, and support to enhance the child’s development.
- Transportation and related costs – DEIC Manager
- Entire Service Coordination & providing or reimbursing the cost of travel necessary to enable a child and family to receive any tertiary level services.
- Referral services following referral guidelines – children who are diagnosed for any of the selected health conditions would receive follow-up referral support and treatment including surgical interventions at tertiary level.
- Documentation and maintenance of case records – Data entry operator
- data storage for service delivery, follow up and research.
Other Services provided under DEICs in Kerala:
- Screening, Diagnostics & Assessment especially defect at birth, developmental delays and disabilities based on specific appointment system through field level RBSK NURSE
- Liasoning for Provision of Aids to Children (hearing aids)
- Coordination of “Hridyam”program for management of congenital heart diseases
- Separate follow up initiative for children born with Clubfoot – coordination of 43 clubfoot clinics established at Selected govt. Hospitals.
- Treatment and follow up support for children born with Cleft lip and palate.
- Entra view Digital Autoscope screening for all children referred to DEICs.
- Separate follow up initiative for children born with Rare diseases like SMA.
- GHRT (Growth Hormone replacement Programme ) – Implemented through DEICs To support isolated growth hormone deficiency in children recommended by a technical committee constituted in 5 medical colleges.
- Day observations
- Digital documentation in single channel acrosskerala through “shalabham” online portal
- Link with other NGO’s special schools, brc, buds etc for ensuring and delegating available services to people
Special Highlight: Mobile Intervention Unit established with the support of Kerala Social Security Mission (KSSM) : Anuyathra Mobile Intervention Units (MIU) acts as an extension services of DEICs, working as fixed day clinics at identified centers in different health blocks. The major services made available under MIU includes – Developmental Therapy, Physiotherapy, Psychology services, Speech cum audiology services and Special education.