• Early intervention is a systematic programme of therapies, exercises and activities designed to address developmental delays specifically experienced by children with DS.
• The modern positive attitude towards people with DS implementing early-intervention programmes are reported to have a positive influence on adaptive and cognitive.
• Intervention means “coming between” any negative and disabling effect that a developmental delay or disability might have on the developmental process in general.
• Intervention is the attempt to minimise or sometimes prevent the impact of the disability or delay on the child’s development.
• Early intervention for the child with DS is important because of the initial typical development until six months followed by delays in certain domains of their development.
• Intervention should not be done in isolation, but a holistic approach should be followed.
• Early intervention for the occupational therapist describes services for children from birth to three years, who have developmental delay or at risk.

• Studies have shown that the progressive slowing of the intellectual development of children with DS can be minimised by the provision of early educational input via time-sensitive interventions.
• Early intervention is important for the child with DS as they were among the first to be “mainstreamed’ in public schools. This came to be because of the efforts of parent advocacy groups. They have been the pioneers in the trend toward inclusion. The international drive for future expectations of children with DS is to mainstream them in regular schools. Therefore, more emphasise should be on early intervention to help more children with DS to be enrolled into “mainstreaming”.
• It includes early-detection, child- and family-centred intervention, and psychological support for parents and interdisciplinary input. The team for the interdisciplinary input should consist of doctors, paediatricians, community doctors, health visitors, occupational therapists, physiotherapists, speech therapists and social.
• The key to success in early intervention is the collaboration between the team members, parents and caregivers within their home or the child-care setting.

• The goals of early-intervention programmes are achieved by providing developmental and therapeutic services for children.
• Support and instructions for their families are part of the programme.

• Early intervention should not be seen as merely training the child in developmental skills, but intervention directs the way the child perceives, explores and interacts with its surroundings.

• Timing: The onset or beginning of the intervention should be early in childhood. Timing, not only the early referrals of children with DS, but the planning of the duration of an intervention programme is essential.
• Intensity and recurrence (per day/week/month/year): Intervention should be part of a daily routine during activities such as feeding, bathing, when picking the child up and dressing and undressing.
• Providing direct learning experiences for the children and caregivers.
• Providing a broad range (breadth of services) of comprehensive services/support such as transportation to- and from intervention sessions, parent training and counseling.
• Attending to individual differences: Not all programmes benefit all children. Programmes need to be tailor-made for both child and family needs and abilities.

• Environmental support: To maintain the effects of early intervention, involving the whole family in decisions which affect the child is important.
• Active involvement and engagement of the parents/caregivers are crucial to effective outcomes of the intervention.
• The provision of applicable, age appropriate information material should be made available with each session to use at home.
• A client-centred approach supports the factors for an effective stimulation programme and should be incorporated.

• Active parental involvement has a positive effect on the development of child with DS.
• Parents interpret early intervention as providing an opportunity to “do something”.
• A common reaction of despondency is shared by parents on learning that their child has DS.
• They experience a multitude of different emotions, such as fear, anger, rejection, guilt, disappointment, denial, lack of self-confidence and self-pity. Caring and looking after a child with DS is an enormous responsibility and may place an added burden on the whole family.
• Therefore, the parent needs support and their role should not be underestimated in planning early intervention.
• To assist parents’ involvement in the intervention process they should be empowered. Empowerment is about facilitating or enabling people to take control of their lives. The role of the professional is to shape, encourage and facilitate whatever self-development is necessary by incorporating the parents. The acquired knowledge and skills when adequate education and training take place encourage a sense of self-worth and then empowerment could follow. The implementation of an early-intervention programme may help to empower the parents who seem powerless when it comes to the induction of their child with DS into mainstream school and society. It is further important to be equipped with the necessary skills to manage their child during the intervention process.

• The family provides the arena for a child to acquire language development and interpersonal relationships, which develops cognitive, language, communication and social skills.
• The importance of the family and the home should be taken in consideration when intervention is planned for a child with DS. The family is the most critical influence on the development of the young child. For the well-being and development of the child’s physical and psychological development the provision of the family is crucial.

Characteristics of an effective intervention with parents are:

• the involvement and,
• education of parents/caregivers and,
• the promotion of positive caregiver-child interactions.

• Interventionists are occupational therapists, early-intervention teachers, physical therapists and speech- and language therapists.
• All the role-players should have a common goal towards early intervention of the child with DS.

• Intervention should emphasise the empowerment of the partnership of all role-players and cooperation in decision-making and programme planning. The role of the interventionist is not only to accelerate the pace of development, but also to empower the parent. This may bring the interventionist outside his/her primary domain of expertise.
• Additional specialised training should be undertaken by interventionists to fully understand the implication of early intervention on the child with DS.

• The therapist-implemented treatment approach in this setting is different from the client-centred therapy approach described in occupational therapy intervention.
• This is the contemporary intervention implemented in consultation sessions according to the scope of practice of each discipline such as occupational therapy, physical therapy and speech and language therapy.

• There are two motor-intervention models, namely Neuro-Developmental Treatment (NDT) and Developmental Skills models and Sensory Motor Integration.
• It is important to state that these service models use individual treatment or small groups, frequent treatment delivery (once or twice a week or month) and require strict discipline of the parent and the interventionist.

• Neuro-developmental treatment was developed in England by Berta and Karel Bobath as a “living concept”, specifically for the treatment of children with Cerebral Palsy.

• This client-centred therapy approach involves treating the child with the objective of inhibiting abnormal tone and facilitating automatic reactions, such as righting and equilibrium, as a means to promote normal movement patterns to enhance function.

• The Developmental Skills sessions focus on children’s play and general motor activity.
• “Developmental Skills programs focus on the learning and mastery of a set of normally sequenced motor milestones; with intervention the target is identified from skills at the next higher level.”

• This type of approach assumes that children will advance to a higher level of motor development and therefore independent functioning will take place through practice and reinforcement.

• Sensory stimulation with respect to integration is an innate neurobiological process that refers to the interpretation of sensory information about the environment received through the senses, to adapt motor response.
• Sensory Integration is “the organization of sensory input for use”.
• A child’s growth and development are dependent on the development of the tactile, proprioceptive and vestibular systems, ocular motor coordination and oral structures, so that the child may be sensory modulated in order to participate successfully in activity.

• It was found that children with DS have less efficient reach strategies and may show specific praxis deficits in early development, especially to sensory components of daily activities related to motor performance.
• Early-intervention programmes should involve activities that allow the experience of sensory information, which is beneficial for function and development.

• Parent-implemented developmental training implies that parents need to be involved in the assessment process, not only to provide information about their child’s development and needs, but they should gain awareness of their child’s early development.
• This intervention is based on activities that can readily be incorporated in the daily care routines of the infants. The parent-implemented developmental training is found to be more effective.

• The “Developmental Resource Stimulation Programme” (DRSP) is an example of a parent-implemented developmental training programme incorporating Neuro-Developmental Treatment (NDT).

• A client-centred therapy approach involves the intervention models known to health professionals, specifically occupational therapists.
• The occupational therapist is particularly well positioned to act as interventionist and to help in the intervention process of the child with DS.
• As client-centred therapy approach is a key to the occupational therapist’s practice, with the client being at the centre of intervention.

• The use of intervention approaches conducted by an experienced occupational therapist has proven to be effective for improvements in occupational performances (all activities of person with DS). This evidently leads to evidence-based practices.
• Evidence-based practice is a type of intervention in which the professional uses research as a practice and problem-solving tool.

• To respect the clients and their families and the choices they make;
• To recognise that clients and families have the definitive responsibility for choices about daily activities and the therapeutic services;
• To provide information including physical comfort and emotional support with the emphasis on individual-centred communication;
• To facilitate client participation in all the aspects of the therapy service, including decision-making;

• To present a flexible, individualised occupational therapy service;
• To facilitate the client’s capacity to solve their occupational performance issues as in this study more independence for the child with DS;
• To recognise and focus on the relationship between the person-environment-occupation relationship.