Developmental Delay Clinical Trial
Official title:
Early Intervention Therapy for Children With Delayed Development: Enabling Access in India's Rural Communities
This study is a cohort longitudinal design, also known as within subject repeated measures' design to measure the impact of an early identification and intervention program being implemented by Amar Seva Sangam (ASSA), an Indian non-government organization in South India. The primary objective of the Early Intervention (EI) Village-Based Rehabilitation (VBR) program is to increase access to early identification and early intervention therapy to enhance physical, cognitive, language, social and emotional development of children with developmental delays. The primary outcome will be the creation of developmental trajectory of girls and boys with developmental delay who are receiving village based early intervention therapy in rural India, aged 0 - 6 years based on the Gross Motor Function Measure - GMFM (children with cerebral palsy only), Functional Independence Measure - wee-FIM, Functional Assessment Checklist for Programming - FACP, Communication Developmental Eclectic Approach to Language Learning - CDDC and Canadian Occupational Performance Measure - COPM. Secondary outcomes will be the effect of therapy compliance rates on development in girls and boys with developmental delay, the effect of therapeutic approach on development in girls and boys with developmental delay, improved enrolment in school for children with developmental delays from age 3 to 6; and, improved parent/caregiver knowledge, attitude, behavior and confidence in caring for their child with developmental delay.
This study is a cohort longitudinal design, also known as within subject repeated measures'
design to measure the impact of an early identification and intervention program being
implemented by Amar Seva Sangam (ASSA), an Indian non-government organization in South India.
The primary objective of the Early Intervention (EI) Village-Based Rehabilitation (VBR)
program is to increase access to early identification and early intervention therapy to
enhance physical, cognitive, language, social and emotional development of children with
developmental delays. The primary outcome will be the creation of developmental trajectory of
girls and boys with developmental delay who are receiving village based early intervention
therapy in rural India, aged 0 - 6 years based on the Gross Motor Function Measure - GMFM
(children with cerebral palsy only), Functional Independence Measure - wee-FIM, Functional
Assessment Checklist for Programming - FACP, Communication Developmental Eclectic Approach to
Language Learning - CDDC and Canadian Occupational Performance Measure - COPM. Secondary
outcomes will be the effect of therapy compliance rates on development in girls and boys with
developmental delay, the effect of therapeutic approach on development in girls and boys with
developmental delay, improved enrolment in school for children with developmental delays from
age 3 to 6; and, improved parent/caregiver knowledge, attitude, behavior and confidence in
caring for their child with developmental delay.
For each child with a developmental delay who is enrolled in the early intervention program,
a detailed care plan will be developed by the rehabilitation professional(s) who will provide
the care based on the specific needs of the child. A trained community rehabilitation worker
(CRW) will implement the care plan with a focus on the one or more domains where delays were
identified (i.e. speech, motor, cognition). The intervention will be delivered either within
the child's home (home based rehabilitation) or at an local Early Intervention Parent
Participation Centre (EI PPCs) (centre based care). Each child will receive a minimum of one
therapy session per week by the CRW and a monthly therapist visit (i.e., physical therapist,
occupational therapist, special educator and/or speech therapist) for home based care. In
center based care daily therapy will be available by either a CRW or specialist. In addition,
monthly team meetings will be held by the specialists and CRWs to monitor progress and modify
or adapt therapy plans as needed. Therapy will be tailored based on the needs of the
individual child and will follow current evidence-based practice. The investigators will do
evaluations using the standardized scales noted above (GMFM, WEE FIM, COPM, FACP and COM
DEALL) every 6 months to monitor the progress of the child.
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