DISABILITY AND INTERVENTION

The Italian experience

Dr. Maria Di Nocera

University of Rome La Sapienza.
Faculty of Psychology
mariadinocera@libero.it

Process of taking care

It s not a care, but a project based on developmental
needs of the child and his familiy.
Carachterized by continuity and globality of the
intervention in different phases of developmental cicle
of life of the child with disability

Necessity of a protocol of taking care (04/04/1996).

Actually this isnt a praxis but theory, yet.

Process of taking care

Social
support

Social
Services

Chil
d
Family
Therapeutic
and
rehabilitation
services

Process of taking care

Different phases:
1. Communication of diagnosis
2. Sending and entrusting the family and the child to specific
services and professional figures
3. Evaluation process and monitoring of development of the
child
4. Rehabilitative intervention (child and family)
5. Contacts with schools and services
6. Construction of a social network of formal and informal
support

National Health Services

(NHS)
Department for Mother and Childs
Health and Rehabilitation in
Developmental Age
0-14 years

Neuropsychiatrist of
the evolutive age
Psychologist
Social operator
Logotherapist

Adolescence???

Department for Mental

Health
16 years and more

Therapist for motor

skills and
rehabilitation
Psychiatrist,
Neurologist
Geriatricist, Social
operator
Therapist for motor
skills and

National Health Services

(NHS)
Department for Mother and Childs
Rehabilitation in Developmental Age
0-14 years

Health

and

Observing the child and evaluating his abilities

Attesting and certificating the disability
Drafting the Functional Diagnosis (areas : cognitive, relational
, linguistic, perceptive, neuropsychologic, motricity, autonomy)
Programming and monitoring rehabilitative, therapeutic and
educational intervention
Counseling for families
Documents

National Health Services (NHS)

Public
services
(ASL)

Centres and
structures of
rehabilitation
and other
services with
agreement by
NHS

Italian Association Down

People
It is born like an Association
composed by parents of Down
People.
During years had been creating
many services for families, working
together with services, not taking
the place of them.

Italian Association Down People

Research
A research about analysis of needs of families with
children affected by D.S.points out differents main
questions :
1.

2.
3.

4.
5.

What is D.S. (causes, consequences, possibility of

rehabilation)?;
What the family can do for the child?
Which kind of intervention (medical, educational,
rehabilitative) is necessary for the child?;
Which are other families needs, and what do they do?
Which are services, professional figures refers to?

Italian Association People affected by

Down Syndrome
Model of intervention:

Early intervention
Information and Counseling Service
Contacts with schools
Contacts with social and rehabilitative
services
Groups for parents
Interventions for adolescents and
adults

Early intervention
It is a therapeutic and rehabilitative project for children with
disability in early age. Its objectives are:
1.
2.
3.

Improving capacities of the child;

Limiting conditions which can create other handicaps;
Promoting and supporting family process af adaption and
elaboration

It is based on two main principles:

Plurality of disciplines and theoretical approaches (medicine,

psychology, education, social assistance, rehabilitation) and
professional figures;
Considering the needs of the child with disability within the family
contest;
Giving significancy to the contest

Information and counseling service

1. Welcome to new families by parents, old
members of the Association
2. Counseling between parents and social
operator
3. Medical visit. Evaluation

4. Counseling between parents and the clinical

psychologist
5. Counseling between parents and the
developmental psychologist

Groups for parents

Since differents years the IADP have been working with families forming
support groups of 7-8 couples of parents , divided on the age of
children .
Groups of parents meet once every month, toghether with a
psychologist, leader of the group, and an observer.
The objectives of this experience were:
1.discussing problems about Syndrome;
2. sharing experience among parents;
3. thinking about new educational strategies for children;
4. exploiting parents abilities; increasing formal and informal social support
network.
5. Increasing parents own resources and to improve their Quality of Life
At the end of the experience, authors evaluated the results of the
intervention trought two methods: an individual questionnaire and a
gruppal interview. Results demonstrate the efficacy of the experience
about individual stile of coping, self-efficacy, partecipation and
communication in the group.

Intervention for adolescents and

adults

Counseling for families about sexuality, possibility of

work, project for life;
Organizing groups for adolescents about autonomy skills
;
Creating possibility of work for adults persons with
Down Syndrome;
Monitoring the introduction to work;
Creating family-houses in which people can live
automally with other persons.

Contacts with schools

FAMILY

IADP

CHIL
D

REHABILITATIV
E and SOCIAL
SERVICES

SCHOO
L

In which way, HOW:

Parteciping together with the teachers to the first phase of

welcome of the child and the family (separation,
attachment);
Parteciping to the observation and evaluation of the child at
school;
Partecipating to the phase of programming;
Monitoring the work of teachers in progress;
Partecipating to the GLH (Group of work for handicap)
together with other services;
Functioning as a bridge for the continuity from an order of
school to another (kinder-garten, nursery school, primary
school, secondary school)

LEGISLATION ABOUT DISABILITY

AND SCHOOL

Law 1859/62: Creation of special class for students with

disability (principally sensorial disability)

Law N. 517/1977: Closing of special schools. Students

with disability were included in normal class with a
special teacher (1:4)

Law 104/92 : Integration of students with disability

Ordinance 02/24/1994: Collaboration with local

structures and NHS

Integration at school
INTEGRATION

INTRODUCTION

It s a global process that

involve the person with
disability and the contest
(family, school).

The child and the contest

adjust each to the other,
reciprocally.

Intrusivity gived by a
foreign body which enters
in a system already
existent.

Specific objectives (social

cognitive, comunicative) for
the child trough an
individualized program (IEP).

Role of teachers;

Creation of GLH (Group of

work for handicap)

The child adjust to the

contest.
The one objective was
the socialization
No individualized
program
No work in equipe

Main points for

integration

Collaboration
with NHS

Functional
Diagnosis

Functional
Profile
Individualized
Educational
Programm
Activities
for the
didactics

Local Sanitary Services

Multidisciplinary equipe of
specialists
School Group of work

School Group of work

Special teacher/team teacher

Integration process
Variables
influencing directly
the result of the
process

Destroing factors

Variables
influencing
negatively the
result of the
process

Determinants
factors

Integration

Mediator
factors
Variables
describing
effects of the
process, have
impacts on other
parts of the

Determinant factors for a good

process of integration

Flexibility in the organization;

Presence of additional resources;
Cooperation and communication school-family;
Cooperation with social and rehabilitative services;
Cooperation among teachers (special and curricular);
Direct involvement of the school s manager;
The real construction of a project;
Effective evaluation and oservation instruments;
Attention to time and space