Professionals’ perspectives on early intervention in Croatia: Comparing home - and - center based service quality
Ključne reči:
rana intervencija; percepcije stručnjaka; kvalitet usluge; porodično usmeren pristup
Sažetak
Uvod: Usluga rane intervencije ima ključnu ulogu u podršci deci sa razvojnim rizicima i njihovim porodicama. U Hrvatskoj se RI može pružati u porodičnom domu ili u specijalizovanim ustanovama, ali malo se zna o tome kako stručnjaci procenjuju kvalitet ovih modela usluga. Ciljevi: Cilj istraživanja bio je ispitati percepcije stručnjaka o kvalitetu usluge rane intervencije, uz poređenje modela koji se realizuju u domu porodice ili u ustanovi, kao i da se utvrdi da li se te percepcije razlikuju u odnosu na profesionalno iskustvo, obrazovanje i učestalost pružanja usluga.
Metode: U istraživanju je učestvovalo 67 stručnjaka iz različitih delova Hrvatske (91% žena; medijana starosti = 32 godine). Medijana profesionalnog iskustva bila je 13 godina, od čega 6 u oblasti rane intervencije. Percepcije su procenjivane pomoću adaptirane hrvatske verzije Inventara kvalitete centara za ranu intervenciju. Razlike između modela analizirane su pomoću t-testa za zavisne uzorke, a regresionim analizama su ispitani prediktori razlika. Rezultati: Ukupne ocene kvaliteta bile su značajno više za uslugu u domu porodice (M = 3.9, SD = 0.54) nego za uslugu u ustanovi (M = 3.6, SD = 0.30; p = .006, Cohen’s dz = 0.36). Najveće razlike u korist modela u domu odnosile su se na uključivanje deteta i porodice, saradnju sa roditeljima i roditeljske kompetencije (sve p < .001). Iskustvo i postdiplomska specijalizacija nisu bili značajni prediktori, dok je učestalost rada u domu bila značajna (B = 0.154, p = .037). Zaključak: Stručnjaci su kvalitet rane intervencije procenjivali višim kada se usluge pružaju u domu porodice, naročito u oblastima saradnje i angažovanja porodice. Češće iskustvo u radu u porodičnom okruženju doprinosi boljem prepoznavanju prednosti ovog pristupa, što ukazuje na potrebu za širenjem porodično orijentisanih, kućno zasnovanih usluga rane intervencije u Hrvatskoj.
Reference
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18. Hadders-Algra M. (2021). Early Diagnostics and Early Intervention in Neurodevelopmental Disorders-Age-Dependent Challenges and Opportunities. Journal of clinical medicine, 10(4), 861. https://doi.org/10.3390/jcm10040861
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21. Jimenez, M. E., Barg, F. K., Guevara, J. P., Gerdes, M., & Fiks, A. G. (2012). Barriers to evaluation for early intervention services: parent and early intervention employee perspectives. Academic pediatrics, 12(6), 551–557. https://doi.org/10.1016/j.acap.2012.08.006
22. Johnston M. V. (2004). Clinical disorders of brain plasticity. Brain & development, 26(2), 73–80. https://doi.org/10.1016/S0387-7604(03)00102-5
23. Kosher, H., & Gross-Manos, D. (2024). Children's participation in everyday life: An international overview. Children & Society, 38, 1899–1919. https://doi.org/10.1111/chso.12852
24. Landy, S., i Menna, R. (2006). Early intervention with multi-risk families: An integrative approach. Baltimore: Paul H. Brookes Publishing Co.
25. Lučić L. (2019). Parents of Children with Developmental Difficulties and Parents of Typically Developed Children: What Happens in a Year?. Behavioral sciences (Basel, Switzerland), 10(1), 4. https://doi.org/10.3390/bs10010004
26. Ljubešić,M. (2008). Rana intervencija:gdje smo i kuda idemo? Zbornik “Različiti pristupi i zbornici u ranoj dijagnostici i (re)habilitaciji djece s poteškoćama u razvoju”. Dnevni centar za rehabilitaciju “Slava Raškaj”, Rijeka, 5-12.
27. Mateos-Aparicio, P., & Rodríguez-Moreno, A. (2019). The Impact of Studying Brain Plasticity. Frontiers in cellular neuroscience, 13, 66. https://doi.org/10.3389/fncel.2019.00066
28. Matijaš, T., Bulić, D. i Kralj, T. (2019). Timski pristup u ranoj intervenciji u djetinjstvu. Medicina Fluminensis, 55 (1), 16-23. https://doi.org/10.21860/medflum2019_216318
29. Matthews, E. J., Puplampu, V., & Gelech, J. M. (2021). Tactics and Strategies of Family Adaptation among Parents Caring for Children and Youth with Developmental Disabilities. Global qualitative nursing research, 8, 23333936211028184. https://doi.org/10.1177/23333936211028184
30. Milić Babić, M. (2010). Socijalna podrška, obilježja roditelja i djeteta kao odrednice doživljaja roditeljstva. Doktorska disertacija. Zagreb: Pravni fakultet, Studijski centar socijalnog rada.
31. Montaño-Merchán, M., Sanz-Ponce, R., Padilla-Bautista, L., & Calero-Plaza, J. (2025). The voice of families: Perceptions of family-centred practices and natural environments in early intervention in Spain. Children, 12(8), 1068. https://doi.org/10.3390/children12081068
32. Moore, T.G. (2012). Rethinking early childhood intervention services: Implications for policy and practice. Murdoch Children's Research Institute.
33. Nelson, C. A., Sullivan, E., & Engelstad, A. M. (2024). Annual Research Review: Early intervention viewed through the lens of developmental neuroscience. Journal of child psychology and psychiatry, and allied disciplines, 65(4), 435–455. https://doi.org/10.1111/jcpp.13858
34. Pacheco-Molero, M., Morales-Murillo, C., León-Estrada, I., & Serrano, A. M. (2025). Barriers perceived by professionals in family-centered early intervention services: A systematic review of the current evidence. International Journal of Early Childhood, 57(3), 357–377. https://doi.org/10.1007/s13158-024-00401-5
35. Romero-Galisteo, R. P., Gálvez Ruiz, P., Blanco Villaseñor, A., Rodríguez-Bailón, M., & González-Sánchez, M. (2020). What families really think about the quality of early intervention centers: a perspective from mixed methods. PeerJ, 8, e10193. https://doi.org/10.7717/peerj.10193
36. Roggman, L. A., Boyce, L. K., & Cook, G. A. (2009). Keeping Kids on Track: Impacts of a Parenting-Focused Early Head Start Program on Attachment Security and Cognitive Development. Early Education and Development, 20(6), 920–941. https://doi.org/10.1080/10409280903118416
37. Spittle, A. J., & Treyvaud, K. (2016). The role of early developmental intervention to influence neurobehavioral outcomes of children born preterm. Seminars in Perinatology, 40(8), 542–548. https://doi.org/10.1053/j.semperi.2016.09.006
38. Swanson, J., Raab, M., & Dunst, C. J. (2011). Strengthening family capacity to provide young children everyday natural learning opportunities. Journal of Early Childhood Research, 9(1), 66–80. https://doi.org/10.1177/1476718X10368588
39. Šarčević Ivić Hofman, I., Wagner Jakab, M., & Kiš Glavaš, S. (2024). Professionals’ satisfaction with early support services: The role of self assessed knowledge. Arhiv za psihijatriju i psihologiju, 60, 109–120. https://doi.org/10.20471/june.2024.60.02.03
40. UNICEF (2020). Analiza usluga rane intervencije u Hrvatskoj—Analiza stanja i preporuke. RISE Institut za UNICEF-ov ured za Hrvatsku.
41. Validžić Požgaj, A. (2018). Rana intervencija usmjerena obitelji (Poslijediplomski specijalistički rad). Edukacijsko-rehabilitacijski fakultet Sveučilišta u Zagrebu.
42. Vočanec, D., Šogorić, S., & Vajagić, M. (2018). Kako planirati sveobuhvatne intervencije u Republici Hrvatskoj? Prikaz modela razvoja javne politike ulaganja u rani razvoj djece. Acta Medica Croatica, 72, 225–232. https://hrcak.srce.hr/199529
43. Wrightslaw (2008). Early Intervention (Part C of IDEA). http://www.wrightslaw.com/info/ei.index.htm
44. Zakon HR. (2022). Zakon o socijalnoj skrbi [Social Welfare Act], Section 10, Article 97(1), Article 98(2). https://www.zakon.hr/z/222/Zakon-o-socijalnoj-skrbi
2. Barton, E. E., & Fettig, A. (2013). Parent-Implemented Interventions for Young Children With Disabilities: A Review of Fidelity Features. Journal of Early Intervention, 35(2), 194-219. https://doi.org/10.1177/1053815113504625
3. Bouillet, D. (2010). Izazovi integriranog odgoja i obrazovanja. Zagreb: Školska knjiga.
4. Bruder, M. B. (2010). Early childhood intervention: A promise to children and families for their future. Exceptional Children, 76(3), 339–355. https://doi.org/10.1177/001440291007600306
5. Carter, A. S., Messinger, D. S., Stone, W. L., Celimli, S., Nahmias, A. S., & Yoder, P. (2011). A randomized controlled trial of Hanen’s ‘More Than Words’ in toddlers with early autism symptoms. Journal of Child Psychology and Psychiatry, 52(7), 741–752. https://doi.org/10.1111/j.1469-7610.2011.02395.x
6. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates.
7. Damiano, D. L., & Longo, E. (2021). Early intervention evidence for infants with or at risk for cerebral palsy: an overview of systematic reviews. Developmental medicine and child neurology, 63(7), 771–784. https://doi.org/10.1111/dmcn.14855
8. Demarin, I.M. (2019). Rana intervencija nekad i sad. Logopedija, 9 (1), 23-27. https://doi.org/10.31299/log.9.1.4
9. Dixon, D. R., Burns, C. O., Granpeesheh, D., Amarasinghe, R., Powell, A., & Linstead, E. (2016). A Program Evaluation of Home and Center-Based Treatment for Autism Spectrum Disorder. Behavior analysis in practice, 10(3), 307–312. https://doi.org/10.1007/s40617-016-0155-7
10. Dobrova Krol, N., Serrano, A. M., Van Loen, N., Espe Sherwindt, M., Blackburn, C., Grigorova, S., ... & Fričová, M. (2019). Early Childhood Intervention in Bulgaria, Hungary, Poland, Romania and Slovakia: A situation analysis based on the Developmental Systems Model. Eurlyaid.
11. dos Santos, R., Isakov, A. B., Martins, C., Antunes, A. P., Zegarac, N., & Nunes, C. (2024). Professional Skills in Family Support: A Systematic Review. Social Sciences, 13(3), 176. https://doi.org/10.3390/socsci13030176
12. Douglas, S. N., Meadan, H., & Schultheiss, H. (2022). A meta-synthesis of caregivers’ experiences transitioning from early intervention to early childhood special education. Early Childhood Education Journal, 50(2), 1–13. https://doi.org/10.1007/s10643-021-01165-6
13. Dunst, C. J. (2017). Research Foundations for Evidence-Informed Early Childhood Intervention Performance Checklists. Education Sciences, 7(4), 78. https://doi.org/10.3390/educsci7040078
14. Dunst, C. J., & Espe-Sherwindt, M. (2016). Family-centered practices in early childhood intervention. In B. Reichow, B. A. Boyd, E. E. Barton, & S. L. Odom (Eds.), Handbook of early childhood special education (pp. 37–55). Springer. https://doi.org/10.1007/978-3-319-28492-7_3
15. Duraku, Z. H., Blakaj, V., Shllaku Likaj, E., Boci, L., & Shtylla, H. (2022). Professional training improves early education teachers’ knowledge, skills, motivation, and self-efficacy. Frontiers in Education, 7, Article 980254. https://doi.org/10.3389/feduc.2022.980254
16. Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191. https://doi.org/10.3758/BF03193146
17. Guo, L. (2024). Home-based parental involvement and children’s language competence: A systematic review of parent-involved interventions. European Journal of Special Needs Education, 39(5), 779–796. https://doi.org/10.1080/08856257.2024.2421112
18. Hadders-Algra M. (2021). Early Diagnostics and Early Intervention in Neurodevelopmental Disorders-Age-Dependent Challenges and Opportunities. Journal of clinical medicine, 10(4), 861. https://doi.org/10.3390/jcm10040861
19. IDEA - Individuals with Disabilities Education Act. (2018). Part 303 (C): Early Intervention Program for Infants and Toddlers with Disabilities. U.S. Department of Education. https://sites.ed.gov/idea/
20. Inguaggiato, E., Sgandurra, G., & Cioni, G. (2017). Brain plasticity and early development: Implications for early intervention in neurodevelopmental disorders. Neuropsychiatrie de l’Enfance et de l’Adolescence, 65(5), 299–306. https://doi.org/10.1016/j.neurenf.2017.03.009
21. Jimenez, M. E., Barg, F. K., Guevara, J. P., Gerdes, M., & Fiks, A. G. (2012). Barriers to evaluation for early intervention services: parent and early intervention employee perspectives. Academic pediatrics, 12(6), 551–557. https://doi.org/10.1016/j.acap.2012.08.006
22. Johnston M. V. (2004). Clinical disorders of brain plasticity. Brain & development, 26(2), 73–80. https://doi.org/10.1016/S0387-7604(03)00102-5
23. Kosher, H., & Gross-Manos, D. (2024). Children's participation in everyday life: An international overview. Children & Society, 38, 1899–1919. https://doi.org/10.1111/chso.12852
24. Landy, S., i Menna, R. (2006). Early intervention with multi-risk families: An integrative approach. Baltimore: Paul H. Brookes Publishing Co.
25. Lučić L. (2019). Parents of Children with Developmental Difficulties and Parents of Typically Developed Children: What Happens in a Year?. Behavioral sciences (Basel, Switzerland), 10(1), 4. https://doi.org/10.3390/bs10010004
26. Ljubešić,M. (2008). Rana intervencija:gdje smo i kuda idemo? Zbornik “Različiti pristupi i zbornici u ranoj dijagnostici i (re)habilitaciji djece s poteškoćama u razvoju”. Dnevni centar za rehabilitaciju “Slava Raškaj”, Rijeka, 5-12.
27. Mateos-Aparicio, P., & Rodríguez-Moreno, A. (2019). The Impact of Studying Brain Plasticity. Frontiers in cellular neuroscience, 13, 66. https://doi.org/10.3389/fncel.2019.00066
28. Matijaš, T., Bulić, D. i Kralj, T. (2019). Timski pristup u ranoj intervenciji u djetinjstvu. Medicina Fluminensis, 55 (1), 16-23. https://doi.org/10.21860/medflum2019_216318
29. Matthews, E. J., Puplampu, V., & Gelech, J. M. (2021). Tactics and Strategies of Family Adaptation among Parents Caring for Children and Youth with Developmental Disabilities. Global qualitative nursing research, 8, 23333936211028184. https://doi.org/10.1177/23333936211028184
30. Milić Babić, M. (2010). Socijalna podrška, obilježja roditelja i djeteta kao odrednice doživljaja roditeljstva. Doktorska disertacija. Zagreb: Pravni fakultet, Studijski centar socijalnog rada.
31. Montaño-Merchán, M., Sanz-Ponce, R., Padilla-Bautista, L., & Calero-Plaza, J. (2025). The voice of families: Perceptions of family-centred practices and natural environments in early intervention in Spain. Children, 12(8), 1068. https://doi.org/10.3390/children12081068
32. Moore, T.G. (2012). Rethinking early childhood intervention services: Implications for policy and practice. Murdoch Children's Research Institute.
33. Nelson, C. A., Sullivan, E., & Engelstad, A. M. (2024). Annual Research Review: Early intervention viewed through the lens of developmental neuroscience. Journal of child psychology and psychiatry, and allied disciplines, 65(4), 435–455. https://doi.org/10.1111/jcpp.13858
34. Pacheco-Molero, M., Morales-Murillo, C., León-Estrada, I., & Serrano, A. M. (2025). Barriers perceived by professionals in family-centered early intervention services: A systematic review of the current evidence. International Journal of Early Childhood, 57(3), 357–377. https://doi.org/10.1007/s13158-024-00401-5
35. Romero-Galisteo, R. P., Gálvez Ruiz, P., Blanco Villaseñor, A., Rodríguez-Bailón, M., & González-Sánchez, M. (2020). What families really think about the quality of early intervention centers: a perspective from mixed methods. PeerJ, 8, e10193. https://doi.org/10.7717/peerj.10193
36. Roggman, L. A., Boyce, L. K., & Cook, G. A. (2009). Keeping Kids on Track: Impacts of a Parenting-Focused Early Head Start Program on Attachment Security and Cognitive Development. Early Education and Development, 20(6), 920–941. https://doi.org/10.1080/10409280903118416
37. Spittle, A. J., & Treyvaud, K. (2016). The role of early developmental intervention to influence neurobehavioral outcomes of children born preterm. Seminars in Perinatology, 40(8), 542–548. https://doi.org/10.1053/j.semperi.2016.09.006
38. Swanson, J., Raab, M., & Dunst, C. J. (2011). Strengthening family capacity to provide young children everyday natural learning opportunities. Journal of Early Childhood Research, 9(1), 66–80. https://doi.org/10.1177/1476718X10368588
39. Šarčević Ivić Hofman, I., Wagner Jakab, M., & Kiš Glavaš, S. (2024). Professionals’ satisfaction with early support services: The role of self assessed knowledge. Arhiv za psihijatriju i psihologiju, 60, 109–120. https://doi.org/10.20471/june.2024.60.02.03
40. UNICEF (2020). Analiza usluga rane intervencije u Hrvatskoj—Analiza stanja i preporuke. RISE Institut za UNICEF-ov ured za Hrvatsku.
41. Validžić Požgaj, A. (2018). Rana intervencija usmjerena obitelji (Poslijediplomski specijalistički rad). Edukacijsko-rehabilitacijski fakultet Sveučilišta u Zagrebu.
42. Vočanec, D., Šogorić, S., & Vajagić, M. (2018). Kako planirati sveobuhvatne intervencije u Republici Hrvatskoj? Prikaz modela razvoja javne politike ulaganja u rani razvoj djece. Acta Medica Croatica, 72, 225–232. https://hrcak.srce.hr/199529
43. Wrightslaw (2008). Early Intervention (Part C of IDEA). http://www.wrightslaw.com/info/ei.index.htm
44. Zakon HR. (2022). Zakon o socijalnoj skrbi [Social Welfare Act], Section 10, Article 97(1), Article 98(2). https://www.zakon.hr/z/222/Zakon-o-socijalnoj-skrbi
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