Vietnam Studies Show Early Intervention Critical for Disabled Children

Photo courtesy of Hue College of Medicine and Pharmacy

Fogarty has supported research into the impact

of early intervention for children with intellectual

disabilities in Vietnam.

By Cathy Kristiansen

Children with intellectual disabilities are commonly regarded as family burdens or sources of shame and pity in Vietnam and many other developing countries. Health and education authorities provide few early intervention services to help these children maximize their skills.

Research can play a key part in changing perceptions by providing evidence that interventions for these children can improve their lives, those of their family members and their communities in general. This prompted Dr. Jin Y. Shin of Hofstra University in New York and her team to demonstrate the impact of personalized therapies on the development of preschool children in two Vietnamese cities. The research received funding from Fogarty's brain disorders program and the Korea Research Foundation.

"If you don't educate these mentally disabled children early, it is going to be extremely difficult to get them to fulfill their potential," Shin said. "But there are very few special education teachers in Vietnam who are qualified to conduct early intervention. This is very necessary research."

Shin and her colleagues conducted a pilot study at Hue College of Medicine and Pharmacy in central Vietnam, enrolling 30 children with mild-to-severe disabilities tied to conditions such as cerebral palsy, Down's syndrome and autism. Half the children were placed on a waitlist for intervention and served as controls; for the others, specialized teachers paid weekly home visits and worked on five developmental areas, including communication, social and emotional development, memory, muscle coordination and sensory organization. The study showed that behaviors in children who received intervention improved significantly over the yearlong trial.

An essential part of the pilot project was inclusion of the children's caretakers. Not only did the teachers conduct developmentally appropriate exercises with the children, but they also showed the caretakers how to do them, so therapy could continue between sessions. "The teachers made sure to allocate some time to train the parents each week, give lots of demonstrations and feedback," Shin said. "When we finish our study, the parents will be left on their own."

Shin recalls one single mother who believed her young son with Down's syndrome would never be able to stand or feed himself. Through various exercises, the boy was coaxed to reach out for rewards at ever increasing heights and distances, and a year later stood, walked, brushed his teeth and could kick a ball. "Parents are very skeptical at first," Shin said. "When they see their kids are improving, that is the point they start to come around."

Shin received a second Fogarty grant to expand her study and add not only more data but also training of specialist teachers. Shifting the project to the Department of Psychology and Pedagogy at the Hanoi National University of Education, her team enrolled 80 children of ages 3 to 6 years, with mild developmental delays. They also hired 20 student teachers interested in developmental disabilities who worked with special education experts to learn the home-based early intervention therapy curriculum and receive on-the-job training. The study used low-tech tools such as balls, simple toys and drawing, and again encouraged caretaker involvement. It is now completed and the results are being prepared for publication.

Fogarty's brain disorders program supported research that would otherwise be difficult to fund in a low-resource country and enabled the training of more specialized educators and researchers, Shin said. "In Vietnam, you don't get to see funding for this type of vigorous science that will stimulate rigorous regimes of clinical and educational work. And there are very few special education teachers and researchers for intellectual disabilities, especially 10 years ago," she said. "Without Fogarty, this type of project was not going to be possible."

Fogarty's Brain Disorders in the Developing World: Research across the Lifespan program is designed to increase research capacity in low-resource countries and help improve neurological health for millions around the globe.