Simeonsson R J
School of Education, University of North Carolina, Chapel Hill 27599-8180.
Int J Rehabil Res. 1991;14(1):1-12. doi: 10.1097/00004356-199103000-00001.
The concept of prevention, while implicit in most early intervention efforts, has not been comprehensively articulated as a basis for conceptualizing early intervention services. The growing recognition of the importance of early identification and intervention for infants and young children, and involvement of the family, are factors which contribute to conceptualizations of services which are preventive in nature. This recognition parallels broader concerns for family support programmes which have a preventive focus and seek to enhance the development of children and families. The purpose of this paper is to present a comprehensive framework for the provision of child and family service by conceptualizing early intervention in terms of levels of prevention. Specifically, the concept of primary, secondary, and tertiary levels of prevention will be presented as a framework suitable to encompass the preventive function of community based rehabilitation. The relevance of early prevention is based on the premise that the condition of childhood disability can be prevented at primary, secondary, and tertiary levels. Viewed in this way, the problem or condition of developmental delay or disability in children can be addressed at each of the three levels to effect a reduction of its expression, its duration or extended impact. Primary, secondary, and tertiary prevention can be implemented in the context of community based rehabilitation to address these goals: (a) enhance development and minimize the potential for delay; (b) minimize the need for special education and related services; and (c) minimize the likelihood of institutional or other restrictive care outcomes.
预防的概念虽然在大多数早期干预工作中是隐含的，但尚未作为概念化早期干预服务的基础得到全面阐述。对婴幼儿早期识别和干预的重要性以及家庭参与的日益认识，是促成具有预防性质的服务概念化的因素。这种认识与对以预防为重点并旨在促进儿童和家庭发展的家庭支持计划的更广泛关注相呼应。本文的目的是通过从预防层面概念化早期干预，提出一个提供儿童和家庭服务的综合框架。具体而言，将提出一级、二级和三级预防的概念，作为一个适合涵盖社区康复预防功能的框架。早期预防的相关性基于这样一个前提，即儿童期残疾状况可以在一级、二级和三级层面得到预防。从这个角度看，儿童发育迟缓或残疾的问题或状况可以在这三个层面中的每一个层面得到解决，以减少其表现、持续时间或长期影响。一级、二级和三级预防可以在社区康复的背景下实施，以实现以下目标：(a) 促进发展并尽量减少延迟的可能性；(b) 尽量减少对特殊教育和相关服务的需求；(c) 尽量减少机构照料或其他限制性照料结果的可能性。
