Alen speaks for the first time: How family-centered early intervention is supporting children

“Mamma, dwaw raiboo” and there you go, one more multicoloured rainbow is drawn with no delay. “Cut, cut, pawachute-balloon” – small scissors are taken out and parachutes and balloons are cut out. “Zoo”, “giraffe”, “cloud”, “lightning”, “yellow, no – this yellow”, “blue”… the chatting goes on and on. And 4-year old Alen does not stop smiling. The whole family – his mother Atanaska, his father Angel and his big sisters are almost like captives of the little commander and carry out every command of his: they colour, cut out, play with playdough, do jigsaw puzzles, play with animal cards, they count. And they welcome every word he utters, overwhelmed by joy. 

A few months ago, the only words that the little boy from Chirpan was able to say were “mommy” and “daddy”. His communication with his family was limited only to asking for some vital things, such as food, water, by uttering unintelligible, guttural sounds and using gestures at that, which the family had to decipher. Not being understood and having no meaningful communication with the others, Alen often had temper tantrums, he was nervous or would isolate himself for hours on end, focused on his mother’s mobile phone, that his parents share.    

In October 2021, concerned that this situation had been going on for far too long, the parents contacted the early childhood development team at the Community Centre in Chirpan. The team, comprised of two psychologists – experts in early childhood development and a social worker, was set up under the European Child Guarantee pilot project in Bulgaria, financed by the European Commission and implemented with the support of UNICEF. The objective of the team is to provide support to families of children such as Alen and to help these families overcome their children’s developmental difficulties. They work with children aged 0 to 7, with a strong focus on children under 3 when the brain is most open to development , according to scientific research. These  teams were set up under the project at two other Community Centres – in Stara Zagora and Sliven. The support they provide is fully free-of-charge for the families. (More details about the project you may find here) 

The approach  

“Everybody in the team is happy and proud of the change we observe in Alen. However,   we should point out that each case is specific and progress depends on numerous factors. We work, for example, with children with autism spectrum disorder, with genetic disorders or disabilities. Often, the change is a much more gradual process and takes much longer to see”

- shared Denitsa Ivanova, Director of the Centre 

Change is inevitable when we empower the family and  when they have the skills needed  to be capable of supporting their child themselves. When the support is available in the home, in the child’s own environment and interventions take place early enough, are  integrated into the daily routine, with assistance  coordinated by a single expert, everyone engaged in working with the child and the parents is building upon each other’s interventions. Change does happen, even if it is not instantaneous, even if it is a challenging”

- Ivanova added. (Further information on what a family-centred early childhood intervention is, you may find in the box.) 

Support for the family as driver for  change  

“I would like to specifically point out that the positive outcome which we observe with Alen is mostly the result of the family’s commitment, their efforts and focus on  seeking of change. We support them on a daily basis but actually, they are the driver of change”, Tihomir pointed out on a number of occasions. And he added:

“They only needed guidance, empowerment and knowledge on how to play a leading role in supporting their child.” 

In the beginning, assisted by the early intervention professionals, parents completed a questionnaire on the child’s skills and abilities. The responses outlined the areas of development where the child had difficulties and where support should be focused. . The second step was studying the family’s habits and relationships. The purpose of this was to offer solutions and advice on how the family may support the child that were as adapted and tailored to the child as possible,  based on their desires and which were the easiest for them to implement. For example, the professionals made use of Atanaska’s hobby of  drawing and recommended many creative activities for her and Alen. 

Every week, Tihomir, the main specialist  from the early intervention team who works with the family, visits the parents and discusses  their son’s progress with them. Following a discussion with the rest of his colleagues, they suggest new developmental games: working with sticks, with glue, cut-outs, colours, jigsaw puzzles, letters and colours...

This approach involves direct work with the family by a single professional while all the others support this main  specialist 

A New, fulfilling family relationship  

“Previously, he was really withdrawn, often absorbed in playing with the mobile phone, as disconnected from family life, not part of the family. We did not have this kind of contact. We needed it, we longed for  it but clearly, we did not have enough knowledge about this”, his mother shared with his  father nodding in agreement. Both of them commented that the support rendered by the early intervention team was key for them to acquire the necessary skills to interact with their son. And it also helped them become a much more tightly-knit family 

“We were guided by what Atanaska was seeking and wanting, by her desire to have a fulfilling relationship for her son in the family and for him to be a part of the family’s daily routine. We do not impose anything. Based on this, we developed an individual plan, integrating the required change in the daily routine in order to achieve the desired outcomes”,  Tihomir explained to share the principles guiding their work. “There is evidence that this approach is much more efficient – the family is with their child 24/7, they know him best and they can best respond to his needs, and at any time in his natural environment. Whereas these consultation-room-type activities and settings, where the child goes for an hour and works only with the professional, without the parents being involved, cannot be integrated in the daily routines and this makes them much less efficient”, Tihomir adds.  

Working together as a family for Alen 

Tihomir and the rest of the early intervention team members shared their hopes that over the course of time the impact of the work they do will become more visible, their services will be much more in demand and they will be more recognizable both by the families and by the other professionals working with young children: GPs, kindergarten staff, etc. It is important that parents approach these teams even when they have minor concerns, since the earlier they identify the child’s developmental difficulties, the sooner the necessary measures will be taken to overcome them and the children will be given a chance to develop their full potential. 

What is a family-centred early childhood intervention? 

It is a  service meant for families taking care of children with developmental difficulties or disabilities, focused on the period from birth to the age of three. Parents receive support in providing nurturing care to their children, becoming more confident and having the necessary information in order to recognise their child’s needs. The support for the family is provided in the child’s natural environment and not in a specialised consultation room or hall since the child learns best in a familiar environment and from  adults they know and trust, while the knowledge acquired can be transferred and applied in various situations. 

The support to every family is provided by a main specialist or key advisor who is the main professional interacting with them, on the basis of an individual family plan. The key advisor of every family is supported by the other professionals in the team and works in transdisciplinary cooperation. Early childhood intervention is aimed at all adults working with the child, including their nursery and kindergarten teams.