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Learning Together: Chapter II - Early Intervention, Child Care & Family Programs

In the United States, much has been written about the importance of early intervention in the development of children. Of all the efforts generated by the "Great Society Program" and the "War on Poverty," it has been the early childhood programs that have had the most impact. The recent reauthorization of the Elementary and Secondary Education Act — the major federal funding for schools and colleges in the United States — gives an even higher priority to early childhood programs. The Mishpahtonim educational-treatment child day care centers — small units of five or fewer children with caretakers providing care in their own homes — and the multi-purpose day care centers offer promising approaches.

The "disintegration of the family" is another problem area that has caused considerable concern in the United States. Although Israel has not experienced family disintegration as severely or as pervasively as in the States, a number of projects, such as HAKEN, focus on strengthening families and assisting them with their special problems. These have applications for America.

Israeli programs provide a broad range of child care services that are aimed at children and their families, with some specifically targeting at-risk or troubled families. A number of these programs are home-based, such as HIPPY and HATAF, and require intensive parent involvement. Some focus on newborn infants and toddlers, others on other preschoolers. Programs also help parents cope with the demands of a newborn child. Still others focus on residential centers but have implications for foster care and day care operations. The "whole care" concept that some Israeli projects are based on has meaning for American programs.

 


HIPPY/HAETGAR — The Home
Instruction Program for Preschool Youngsters

Contact:

Dr. Avima Lombard
NCJW Research Institute
School of Education
Hebrew University Mt. Scopus Campus
Jerusalem 91905, Israel
Tel. (02) 882208, Fax. (02) 322545

Objective:

To prepare children for the elementary school and to enhance their chances for successful integration into the classroom context.

To provide home instruction on parenting skills and child development to mothers of preschool children.

To increase the personal involvement of these mothers in the intellectual development of their children.

To demonstrate to the mothers the importance of their role in the development process.

Target Population:

Mothers of young children and their three- to five-year old children.

Program and Activities:

The HIPPY/HAETGAR Home Instruction Program for Preschool Youngsters has been operating in Israel for more than two decades. HIPPY (or HAETGAR as it is known in Israel) is a program specifically geared for families of low socioeconomic status in which the mothers' educational level is also low. These families tend to be large and to live in overcrowded facilities.

HIPPY is a three-year program for the educational enrichment of three- to five-year olds, provided within the family by the mothers of the preschool participants with the guidance of professional and paraprofessional teams. More than 5,000 families from some 52 communities nationwide participate. This number includes increasing numbers of Ethiopian families and new immigrants from Russia. Well over 100 Arabic families living in Jaffa participate in the program, which has been translated into Arabic.

Since 1982, the HIPPY Program has been offered for implementation in other countries by local operators and local funding through HIPPY INTERNATIONAL. HIPPY learning materials have been translated into English, Spanish, Dutch, Turkish, Berber-Arabic and Papiamento. HIPPY has been replicated in Turkey, Chile, the Netherlands, South Africa and the United States. The largest non-Israeli program is HIPPY-USA, which serves 11,000 families with four- and five-year olds in 83 communities in 23 states.

HIPPY consists of weekly sessions attended by the mother. Every two weeks, a paraprofessional instructor visits the home; on alternate weeks, the mothers meet in a group session with professional early childhood specialists.

During the instructor's home visits, the paraprofessional supplies the mother and child with the following week's workbooks and learning aides and teaches the use of the learning materials through role playing. If the mother cannot deal with the written instructional material, an older child, selected by the mother, is instructed in how to work with the child while the mother watches. Since the focus of the program is on the mother, she is encouraged to participate to the best of her ability. Problems and issues are raised and discussed during the home instruction session.

At the group sessions, there is a review of the progress the mother made with her child the preceding week; discussion of the experiences and problems encountered in the course of working with the child; instruction, through role playing, in the use of the following week's materials. Cultural enrichment activities are provided in such areas as health and hygiene; toys, games and books; the education system in overview; handicrafts; home economics; planning vacation periods and creative utilization of leisure time.

The program has improved the academic achievement of children from socioeconomically deprived backgrounds. It has also changed the behavior patterns and attitudes of mothers, as reflected in mother-child relations and the degree of openness in these relations, an improvement in the mothers' self-images and the perceptions of their image of other family members and a willingness to take part in programs aimed at her personal development and in other community programs.

 


HATAF — Home Activities for
Toddlers and Their Families

Contact:

Dr. Avima Lombard and Hannah Nisel
NCJW Research Institute
School of Education
Hebrew University Mt. Scopus Campus
Jerusalem 91905, Israel
Tel. (02) 882208, Fax. (02) 322545

Objective:

To improve the linguistic skills of both mother and child.

To increase the parents' awareness of the cognitive, emotional and social needs of the child.

To develop the parents' ability to use natural learning situations in the home and in the community for their child's intellectual and personal development.

To enhance the parents' understanding of the importance of positive reinforcements in their child's learning process,

Teach parents suitable techniques for playing with their one-to three-year old child.

Target Population:

Young couples who have a child who is about one-year old, with the mother having no more than 12 years of schooling.

Program and Activities:

HATAF is a two-year home instruction program for young parents, a pre-HIPPY program aimed at training mothers to develop the intellectual abilities of their first and second born one- and three-year olds through more effective parenting.

In the home once a week, in group sessions and in workshops, parents are provided instruction on early childhood education through play activity. Each activity is accompanied by an information sheet explaining the nature and the importance of the activity.

Group instruction is provided every other week and focuses on such child development topics as independence and discipline; personal grooming habits; sleep time and meals; and general cultural enrichment in the areas of children's literature and health care.

In workshops, parents are taught how to make toys and games for their children. Parent-child workshops offer joint activities in movement and dance, music appreciation, creativity, excursions and parties.

Some 1,800 families in 12 communities are currently being served, including Arab mothers in four areas who are taught in Arabic. Eleven special programs were developed for newly arrived Ethiopian immigrants as well as five programs for newly arrived Russian and Caucasian families.

 


HAKEN — “Home Start” Program

Contact:

Aliya Kedem
Children and Youth Services
Ministry of Labor and Social Affairs
10 Yad Harutzim Street, Talpiot
P.O. Box 1260
Jerusalem 93420, Israel
Tel. (02) 708130, Fax. (02) 731640

Objective:

To prevent families from disintegrating and avoid the consequent out-of-home placement of the children.

Target Population:

Families whose members include young children and who are believed to display symptoms of alienation.

Program and Activities:

The HAKEN program is a joint project of the Children and Youth Services Department and the Volunteer Unit of the Ministry of Labor and Social Affairs. Volunteers of various ages and from diverse backgrounds are selected, given a training course and then matched with target families. The volunteers visit "their" families, offer friendship and support and provide assistance in the promotion of more effective and satisfying parent-child relationships. Volunteers operate under the direction of the local Home Start Association.

Each volunteer is obliged to visit with the family once a week for an hour-and-a-half with no specific agenda other than the development of "a relationship between two friends." Usually the volunteer becomes a support figure and confidant for the mothers, sharing her experience and serving as an intermediary with the establishment that is not always receptive to these families.

In Jewish communities, the program begins in the mother's home. Because of cultural differences, the initial contact in Arab towns and villages is usually in a "women's club," visits to the home occur only when meaningful relations have been developed.

In 1994, 21 HAKEN — Home Start programs were operating, four in Arab settings and 17 in Jewish settings. A cross-section of the mothers indicated characteristics such as: one-parent families (33 percent), mothers from second/third generation multi-problem families (14.5 percent), new immigrants (13.5 percent), disabled families (10.5 percent), disabled families (10.5 percent), alcohol/drug addicted families (10.5 percent), families with violence (10.5 percent), families with mental health problems (5.3 percent) and prisoners' wives (2 percent).

The program is based on the need for informal person-to-person relationships. Some HAKEN programs are located in communities where a range of other services are available while others are in settings with few services. Some programs are more connected with other social services than others.

 


Educational Enrichment Center Project

Contact:

Dr. Anita Weiner
Council for the Child in Placement
64 Pinchas Rosen Street
Tel Aviv 69512, Israel
Tel. (03) 6475075, Fax. (03) 6475076

Objective:

To attain the goal of maximum integration into the educational mainstream, the aim is to provide programs that will stimulate and enrich intellectually the children who have been placed in residential centers because their parents are unable to care for them and to help them deal with the emotional issues they face. The goal of the project is to establish two National Education Enrichment Centers where counselors can receive training and materials for providing enrichment in the group homes in which they serve.

Target Population:

The 8,000 young children (under age 14), normal children from malfunctioning families who have been placed in group homes. The immediate target population are the counselors who will be responsible for coordinating enrichment activities in the group homes at which they serve.

Program and Activities:

For the past several years, counselors from approximately 30 of the 85 group homes were selected to be responsible for the coordination of enrichment activities in the group home. These counselors were sent to the National Center once a month for instruction and guidance in the creation and use of stimulating educational activities geared to the needs of disadvantaged children. Ten of these counselors have been given more intensive guidance in the creation of educational enrichment centers within their group homes.

Counselors at residential group homes are responsible for keeping 15 to 30 children stimulated and occupied during the afternoon and evening hours. The development of activity kits at the National Education Enrichment Center has enabled the direct care workers to provide the children with stimulating, enriching educational programs that help them cope more successfully with their emotional burdens, to acquire important and useful knowledge about the world around them and to integrate constructively in their elementary and junior high school studies.

Model activity kits were constructed from inexpensive, easily available materials. The activities include a wife range of subjects, including religious holidays, flowers, well-known personalities, geography and games that help the children identify and be more in contact with their emotions and become familiar with family relationships.

The Council has initiated several other successful projects, but, because of limited funding, has only been able to operate them on very modest scales. These include:

Preventive Dental Hygiene Project. An examination of 75 of the 160 children at one group home by a Professor from the Tel Aviv Faculty of Dentistry disclosed that each child had an average of six to eight cavities. The Social Welfare Ministry purchased basic dental insurance for all 8,000 children but the plan covered only basic dental treatment, not preventive care. A young graduate of Tel Aviv Dental School was hired on a part-time basis and found that the diet included many candies, often at bedtime and that most of the children did not even have toothbrushes. Part-time dental hygienists have now been hired to do the follow-up work after the program was launched.

Summer Camp for Mothers and Children Together. To foster a sense of belonging and identity, all children in residential group care spend every third weekend with their malfunctioning families. This allows young children an opportunity to spend time with their mothers away from the stress and tension in their home. The Council operates a unique summer program that enables young children and their mothers to spend a week together learning to enjoy one another and improve their relationship. A relatively small program, the problems that led to separation between the children and their mothers — e.g., serious neglect, maltreatment, parental drug abuse, mental illness and personality disorders — are longstanding and it is not always possible to prepare many of the mothers for a week of rest and an opportunity to get to know their children. Preparation prior to the camp, however, and follow-up afterward, have a major impact on each mother-child pair. The direct care workers also come to understand the child better and the child's deep need for ongoing contact with their families.

Creative Art Therapy and Art Appreciation Program. Children who have experienced considerable stress and deprivation at home during their early years and are then separated from their families and raised in residential group care, often have difficulty expressing themselves verbally. They are, however, in great need of attention and care and the various forms of art therapy, such as music, art, movement and drama are usually a source of release and renewal. Several years ago, the Council began an experimental art therapy program by introducing teams of art therapists. Almost none of the children in group homes have ever been to a theater. Beginning during the Gulf War, when tensions in the group homes were running high, a coordinator organized specially tailored theater performances, followed by discussions between the children and the actors. These performances have been an enormous success, reaching several thousand children in 25 homes.

Project Rescue. The feeling of abandonment, of not belonging to anyone, of not being the object of anyone's special affection, has a destructive influence on a child's emotional well-being and ability to concentrate in school. The Council has created Project Rescue to strengthen family ties for those children who have minimal contact with their families. In those cases where no family member can be found who is willing to commit to ongoing contact with the child, a volunteer is located. The Council has a part-time volunteer coordinator who runs a training program for more than 150 volunteers. The coordinator matches a child with a volunteer who is committed to long-term contact and then continues contact to help the volunteer deal with the inevitable problems that arise. In addition, volunteers help to arrange outings for children and their families, assist groups of children with their homework and, in general, perform tasks that need to be done in the homes.

 


Mishpahton (Family-Style Day Care):
A Mini Child Day Care Center

Contact:

Aliya Kedem
Children and Youth Services
Ministry of Labor and Social Affairs
10 Yad Harutzim Street, Talpiot
P.O. Box 1260
Jerusalem 93420, Israel
Tel. (02) 708130, Fax. (02) 731640

Objective:

To insure the proper development of children within a small heterogeneous framework designed to promote social integration.

Target Population:

Children aged 6 months to 3 years whose mothers work outside the home or who have been referred to the mishpaton by the local social services in accordance with the Ministry of Labor and Social Affairs criteria regarding children who are at-risk, whose development has been delayed, are from very large families, or whose mother is participating in a vocational rehabilitation program.

Program and Activities:

Mishpahtonim are educational-treatment child day care centers for five children under the supervision of caretakers who operate the centers in their own homes. First launched in the mid-1970s on an experimental basis, drawing on similar models abroad but adapted to the needs of Israeli society.

The care-giver is an independent worker who receives payment for each child under her care in accordance with a contract between her and the operating agency. The care-giver must have at least 10 years of education; a speaking, reading and writing knowledge of Hebrew; normal physical and mental health; be a mother; have some prior experience in caring for children; demonstrate a warm manner; be open to new ideas and able to absorb new material studies; and participate in the required training program.

The care-giver participates in a basic training course that aims to provide an additional stage to assess the capability of the care-giver to operate a mishpahton in her home, provide the care-giver with basic introductory knowledge in subjects connected with running an educational care-providing facility for children of this age and strengthen the professional image of the care-giver in this role. The course uses lectures, workshops, films, group instruction and observation in day care centers to provide instruction in topics such as first aid, child development, behavioral problems of preschoolers, children's diseases, hygiene and health, nutrition, children's literature, the game and its importance, movement and music (rhythm), work with parents and how to use professional literature.

The local coordinator of the mishpahtonim is responsible for locating suitable care-givers, participates in the training course and instructs care-givers on an individual and group basis. The coordinator also prepares a list of children who are candidates from those referred by the Social Service Department or registered as children of working mothers, locates children that need additional professional intervention, works with parents on an individual or group basis and maintains on-going contact with the social, medical and nursing services.

A few years ago, the Ministry confronted the problem of accepting what were called "special children" — e.g., a child with Downs Syndrome, cerebral palsy, blind, deaf, spina bifida or a slow learner. The program has provided additional training for such care-givers and, in some cases, additional staff. By 1989, well over 100 "special children" had been integrated into the program, most successfully.

 


The Multi-Purpose Day Care Center

Contact:

Aliya Kedem
Children and Youth Services
Ministry of Labor and Social Affairs
10 Yad Harutzim Street, Talpiot
P.O. Box 1260
Jerusalem 93420, Israel
Tel. (02) 708130, Fax. (02) 731640

Objective:

To create a high quality, comprehensive support system model for families at-risk with young vulnerable children, one that integrates social services with day care and focuses on the interaction of children and parents that enables preservation of the family.

To prevent the disintegration of the family.

To help parents understand the meaning of relations with their children and the two-way influences of this relationship.

To integrate families referred by social workers with families using the center for alternative care.

To develop and integrate a team consisting of a social worker, a psychologist and other allied professionials to help the children and their parents and support the educational and care-giver staff.

To help care-givers become involved with parents and develop the understanding and interest in their everyday hardships and help them develop the skills of taking care of their children at home.

To help activate the parents as a self-help group by developing informal structures that contribute to nurturing their strengths for coping with everyday problems.

To cultivate better communication between members of the family and orient them to related programs and services.

To develop programs for women that will enable them to join the work force.

Target Population:

At-risk children who are abandoned or physically or sexually abused or being brought up in unsatisfactory conditions. At-risk families include parents that are retarded, drug addicts, in situations of deep poverty, as well as young adolescent mothers. These are families who appear to be potentially at-risk and their social workers have no solutions, or "alienated" families that are not using services available in the community.

Program and Activities:

The guiding concept is a "Social Approach Model" which assumes that the impaired functioning of parents is not pathological but is the result of the differences inherent in the norms and values of the parents and their concept of the needs of their children. The model focuses on the interaction between children and their parents and not on each one as a separate entity.

Multi-purpose Day Care Centers are only created in communities with high risk indicators. The Center is open from 7:00 a.m. until 8:00 p.m. for children ages 3 months to 6 years who stay in there for as many hours as are required to ensure their basic needs. Efforts are made to develop the Center so that it becomes "special" for its community, taking into account the special culture of the neighborhood and the particular needs of the children.

The success of the program is judged on the extent to which family preservation is achieved; parents become more able parents using regular day-care services rather than those for at-risk children; parents develop careers that will raise their status economically and emotionally; drug addicted parents will refer themselves to special programs and children are "ready" at the right age for school.

 


ORION — Home Intervention Program
for Families with Young Children

Contact:

Aliya Kedem
Children and Youth Services
Ministry of Labor and Social Affairs
10 Yad Harutzim Street, Talpiot
P.O. Box 1260
Jerusalem 93420, Israel
Tel. (02) 708130, Fax. (02) 731640

Objective:

To identify and mobilize positive forces within the family as a whole and within its individual members, develop greater sensitivity among family members to the ramifications of disruptive behavior and enhance the attention span and learning abilities of family members.

Target Population:

Families at risk because of faulty parent-child communication patterns; families in which a child is being considered for placement outside the home, although efforts are continuing to find a solution within the community; and children who are candidates for placement outside the home as a last-ditch attempt within the community.

Program and Activities:

ORION is an intensive, short-term home intervention program aimed at improving intra-family communication, using a video camera to reflect the client family's behavior patterns. Essentially, ORION attempts to improve communication within families at-risk employing video cameras as an auxiliary professional tool, adding to the case worker's range of intervention strategies. Video cameras are used as a primary means for exploring intra-family communication regarding day-to-day situations and events, and for recording behaviors with particular emphasis on "body language" and other non-verbal communication.

 


MAMASH Drop-in Center for Infants and Toddlers

Contact:

Ellen Shein
79 Mishmar Hayarden Street
Shikun-Dan
Tel Aviv 69865, Israel
Tel. (03) 6472411, Fax. (03) 6475221

Objective:

To provide a support system to mothers and fathers who are at home with their infants, upgrading and stressing the utmost importance of the job that they have taken upon themselves.

Target Population:

Parents who have newborn children and toddlers at home.

Program and Activities:

The Family Drop-in Center was established to help parents cope with the demands of a newborn child by providing information and support. Located in Tel Aviv's Ramat Hahayal suburb, a neighborhood that is best known as one of Israel's most socially and economically integrated areas.

The Center initially offered breast-feeding advice, nutrition lectures, creative parenting discussions and problem analysis sessions — all provided by qualified doctors, nurses, social workers, psychologists and breast-feeding consultants. Later, the Center's services expanded to include movement classes for toddlers, story hour, puppet shows and arts and crafts classes. Parents enroll with their children at a nominal fee. To contain costs, most professionals working at the Center were asked to donate their time and many did.

Because there is a scarcity of pre-nursery school facilities in Israel, the Center provides parents with a clean, safe environment in which their children can interact with others, acquire basic social skills and enjoy a stimulating atmosphere without experiencing parent-infant separation. The Center provides parents with an opportunity to meet other parents and exchange ideas and problem-solving techniques. For some mothers, it furnishes a "home away from home" in which distraught mothers can drop in to relax and alleviate tensions from the day-to-day challenges of rearing very young children.

MAMASH opens at 9:00 a.m. every day except Saturday and is open for six hours daily. All activities require parent participation. The Center services about 350 families at any given time. The early morning activities are oriented toward the young housebound mothers and their infants with classes divided into age groups (0-4 months, 5-8 months and 8-12 months). Toddlers enjoy a lightly structured program that includes stories, creative crafts and free playtime. There is a special pre-nursery school class held specifically for 2- to 3-year olds that prepares them for the dynamics of the structured frameworks and group programs (the gans) into which most 3-year olds in Israel are placed. In the afternoons, parents working outside the home in the morning hours are provided with a parallel program to that of the mornings for children under two years of age. In addition, the program incorporates special activities in which parents share their quality time with their 2- to 4-year old toddlers. In the evenings, parents who cannot participate during the day are offered enrichment programs, including childbirth courses, La Leche meetings (advice and assistance for breast-feeding babies), parenting courses and informative lectures by local professionals on child care, health, education and development.

The Center is especially helpful to new immigrants who, in addition to readjusting to life with a small child, also face the problem of becoming integrated into Israeli society and learning the Hebrew language. New immigrants are also provided with an opportunity to socialize with their Israeli counterparts in an informal setting — the parents' acclimation being an important contributor to the child's development.