Évaluation des programmes d' ≪ intervention précoce ≫

Abstract

Early intervention include educational and neuroprotection strategies. Early educational strategies are based on the cerebral plasticity concept. Neuroprotection, initially reserved for molecules preventing cell death phenomena, can be extended now to all actions promoting harmonious development and preventing handicaps, and include organisational, therapeutic and environmental aspects. Early stimulation programs have been first devised in United States for vulnerable children who belong to an unfavorable socio-economic category ; positive effects were recorded in school failure rates and social problems ; programs have also beeen launched in several countries for premature infants and infants with a low birth weight, population exposed to a high risk of deficiencies. The programs are targetted either to the child, or to the parents, or combined to provide assistance for both the child and the parents. The programs given the best evaluation are NIDCAP Program in Sweden (Newborn Individualized Developmental Care and Assessment Program), intended for babies < 1500g in neonatal intensive care units, then a longitudinal, multisite program, known as IHDP (Infant Health and Development Program). It was launched in United States for infants < 37 weeks or < 2500 g. Results show that combined parent-child programs are the most useful. Effects on parent- child relationships and on child's cognitive development are especially effective if stimulation is maintained and when mothers have a low level of education.