Early intervention (RI) encompasses the process information, counseling, education and support children who have developmental difficulties or who have a risk factor for developmental abnormalities, due to biological or environmental factors. RI services are provided from the earliest detection of developmental risks, developmental abnormalities, developmental difficulties, or behavioral or mental health needs. Services continue to be provided until the child reaches a typical level of development or switches to other services of appropriate age and / or stage of development.
The developmental needs of the child are complex and require the cooperation of experts of various profiles. RI services are always provided in teamsand which function in an interdisciplinary or transdisciplinary manner. All RI team members are focused on giving support to family members and their education about the best ways to support a child. RI services are family-oriented, but also child-centered. It seeks to empower parents and ensure that parents make all key decisions about their child's goals and the services they receive, while addressing the needs of parents for support. (UNICEF, 2020.)
Guided by the guidelines of the gold standard of modern approach to RI - transdisciplinary team collaboration - experts of the Early Intervention Team of Rovinj Special Hospital are introducing a completely new system of supporting families of children with developmental risks and developmental difficulties. intertwine the professional roles of physiatrist, pediatrician, educational rehabilitator, psychologist, speech therapist and occupational therapist. The functional connection of the Rovinj Special Hospital with the Srebrnjak Children's Hospital also provided clinical support for neuropediatricians.
Effective communication, interaction and cooperation among the members of the Team contributes to the holistic developmental image of the child, which provides the opportunity to provide support according to the unique needs of each child and family.
The only recognized and valid instrument in Croatia for diagnosing autism spectrum disorders is the Observational Protocol for the Diagnosis of Autism - ADOS-2, which is the gold standard in the process of diagnosing autism spectrum disorders.
With the generous funds of the ICF Foundation, during 2021, the realization of the project "Strengthening the capacity of professionals to implement interdisciplinary services of early childhood intervention", The training of experts from the Educational Rehabilitation Team for the Early Intervention Team of the Rovinj Special Hospital for the implementation of the ADOS-2 Observation Protocol has been provided. In this way, it is possible to timely and comprehensively diagnose disorders from the spectrum of autism in the Istrian County and beyond.
Parents whose children have difficulties with social interaction and communication, which are the main determinants of autism spectrum disorders, have so far had to wait more than a year to get a queue for an assessment to confirm or dispel their suspicions. Also, because of that, they often had to travel outside Istria and often pay for the implementation of the ADOS-2 Observation Protocol.
By achieving the goal of the project, parents were given the opportunity to implement the Observation Protocol for the diagnosis of autism in the Special Hospital for Orthopedics and Rehabilitation "Martin Horvat" Rovinj - Rovigno in a short time, at the expense of HZZO.
Various complications that endanger the development of the child can occur during pregnancy, childbirth or immediately after birth. We call these complications "neurorisk factors“. We divide them into the low-risk factors we see in most children and the high-risk factors. In a small number of children (about 3 %), high-risk factors can cause temporary or permanent developmental disorder. The child's neurodevelopment depends on the interaction of the child and the environment and on the compensatory mechanisms by which the brain will try to minimize the damage, and we call this phenomenon the plasticity of the brain. Brain plasticity is the ability of the brain to recover and rebuild.
Interdisciplinary monitoring of a child's neurodevelopment identifies possible developmental disorders in motor, communication, perceptual-cognitive and socio-emotional development, and children with developmental disabilities are included in early intervention programs to eliminate or reduce the possibility of developmental difficulties.
We consider any child who has been a neurorisk child exposed to certain risk factors in pregnancy, during or after childbirth. The extent to which the brain will be damaged and the location depends largely on the gestational age at which the injury occurred, or on the stage of development of the brain itself and its blood vessels. The neurodevelopment of the child depends on the interaction of the child and the environment and about the compensatory mechanisms by which the brain will try to minimize damage. By the way, these are children with dysfunctions and difficulties of sensory integration, motor planning disorders, children with difficulties in fine and gross motor skills, poor organization of behavior and perceptual disorders.
Given the complex clinical picture and difficulties during the growth and development of high-risk children, the need for organized professional teams within the health system has emerged.
In accordance with the development strategy of the Special Hospital for Orthopedics and Rehabilitation "Martin Horvat" Rovinj-Rovigno in 2018, a newly renovated part of the Polyclinic was opened, which houses specialist clinics for pediatric orthopedics and clinics for pediatric physical medicine and rehabilitation, and was consequently founded Center for Early Childhood Intervention whose purpose was to provide effective and comprehensive support to children and families from an early age. As part of the project, it was renovated and equipped Sensory room donations from Istrian companies, individuals and special actions. Assessment and therapy of the youngest patients will be performed through the Early Intervention Team for Children at Neurorisk. It is actually a comprehensive (holistic) institutional approach and support to parents and children from the earliest age to seven years of age, who are at risk or already have developmental disabilities, or children with developmental disabilities and sensory impairments. The County of Istria has provided funds to finance the work of the professional staff pediatrician-neonatologist, clinical psychologist, speech therapist, educational rehabilitator and occupational therapist under the supervision of a specialist in physical medicine and rehabilitation.
