Professionals’ perspectives on early intervention in Croatia: Comparing home - and - center based service quality
Keywords:
early intervention; professional perceptions; service quality; family-centered practice
Abstract
Introduction. Early intervention (EI) services play a crucial role in supporting children at risk of developmental difficulties and their families. In Croatia, EI can be delivered either at home or in specialized centers, yet little is known about how professionals perceive the quality of these service models. Objectives. This study examined professionals’ perceptions of EI service quality, comparing home- and center-based provision, and explored whether perceptions varied according to professional experience, education, and frequency of service delivery. Methods. Sixty-seven professionals from across Croatia (91% female; median age = 32 years) participated. Median professional experience was 13 years, with 6 years in early intervention. Perceptions were assessed using an adapted Croatian version of the Inventory of Quality in Early Intervention Centres. Paired-samples t-tests compared home- and center-based ratings; regression analyses explored predictors of differences. Results: Overall quality ratings were significantly higher for home-based services (M = 3.9, SD = 0.54) than for center-based services (M = 3.6, SD = 0.30; p = .006, Cohen’s dz = 0.36). The largest differences favored home provision in child and family engagement, collaboration with families, and parental competences (all p < .001). Professional experience and postgraduate specialization were not significant predictors, whereas frequency of home-based provision was (B = 0.154, p= .037). Conclusion. Professionals perceived home-based early intervention as higher in quality, particularly in fostering collaboration and family engagement. Greater exposure to home-based practice enhanced recognition of its benefits, underscoring the need to expand family-centered, home-based early intervention services within Croatia’s social welfare system.
References
1. Barnett, M. A., Paschall, K. W., Mastergeorge, A. M., Cutshaw, C. A., & Warren, S. M. (2020). Influences of parent engagement in early childhood education centers and the home on kindergarten school readiness. Early Childhood Research Quarterly, 53, 260–273. https://doi.org/10.1016/j.ecresq.2020.05.001
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
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
Published
2026/03/26
Section
Original Scientific Paper
Copyright (c) 2026 Specijalna edukacija i rehabilitacija
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.