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CNAA / Theses / 2008 / May /

Elaboration of the model of early intervention services for children with disabilities in Republic of Moldova

Author: Ivan Puiu
Degree:doctor of medicine
Speciality: 14.00.33 - Social Medicine and Management
Scientific adviser: Constantin Eţco
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Scientific consultant: Larisa Cuzneţov
doctor habilitat, professor, Chisinau Pedagogical State University "Ion Creanga"
Scientific council:


The thesis was presented on the 28 May, 2008
Approved by NCAA on the 19 June, 2008


Adobe PDF document0.29 Mb / in romanian


early intervention for the child with disabilities, early habilitation model of services, transdisciplinary team, Maternal Behaviour pattern, parents perception in diagnosis information, disability, special educational and medical needs, professional training, curricula in early intervention, information and coaching families, medico-social services.


The purpose of this investigation was to elaborate a model of early intervention services for children with special needs via researching and analyzing the 3 basic elements of this model: a) transdisciplinary team as a vital component of early intervention services for children with disabilities and their families, b) the impact of mother-child interaction on the effectiveness of early intervention services for children with developmental delay and c) professional education in early intervention systems – elaboration of curricula and best practice protocol in informing parents about diagnosis of Cerebral Palsy.

We evaluated the changes in activity of the team of Centre of early Intervention “Voinicel” (transdisciplinary approach) during 2 years of activity, through analysis of team members' opinion and parents perception of changes (interview, questionnaires, focus-group discussions) and ascertained that the Voinicel team are progressing to become a transdisciplinary one; transdiciplinary model is a solution in solving complex developmental problems in early life, there is a necessity for professionals in EI to work together as a team (Wilcoxon coefficient = – 2,955; p<0,005).

For second objective - the study included 20 mothers and 20 their children with Down syndrome. Children were evaluated with the DAYC Scale (Developmental Assessment of Young Children) and mothers' behaviour was coded with the Maternal Behaviour Rating Scale. We used 3 methods of evaluation of mothers' style of interaction: 1) questionnaires, 2) semi-structured interview and 3) videotape recording of mothers while playing with their children. Results from this analysis indicated that in the group of children with relative accelerated development most of mothers were sensitive to child's interest, inventive in playing with the child, responsive to the child's behaviour and 70% of them were using a moderate directive intervention model. The moderate-directive style of mother-child interaction, adapted to the child medical condition and his behaviour, associated with receptive style of interaction, represents an optimal model of parentchild interaction for a good child development in case of developmental problems (χ2 = 10,9; p<0,05). The suggestive style of interaction with affection has more significant influence on socio-emotional development (χ2 = 11,3; p<0,005), communicative domain (χ2 = 9,9; p<0,01) and adaptive-behavioural child abilities (χ2 = 9,3; p<0,01).

In order to collect deep information about which kind of training requirement are regarded as relevant and about which kind of skills should be trained for professionals working in early childhood intervention, a guideline for an qualitative interview has been elaborated. With this guideline, 50 family physicians, 50 parents and 10 professionals in the field of early intervention have been interviewed in order to draw a common picture of necessary knowledge and necessary competencies a specialist of early intervention should have. On this base a draft version of a curriculum has been elaborated, curricula what was partially implemented via elaboration of a practical “Guide of Early intervention services”, didactic materials. For the elaboration of a Guide of best practice in informing parents about diagnosis of Cerebral palsy we analyzed opinions and degree of satisfaction of 40 parents with CP children, using a questionnaire and an semi-structured interview. For evaluation of children we have used the standard method GMFCS - Gross Motor Function Classification System for Cerebral Palsy (Rosembaum P, Palisano R, 1997). As a result of entire research we proposed a model of Early intervention services providing for children with special needs.