PORTAGE HOME-BASED MODEL OF EARLY INTERVENTION

Portage was one of the first models to develop a home-based programme recognising the importance of parents as an integral part of their child’s development. Theresa Ghalaieny

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2074

Readers may have heard the name ‘Portage’, but have little knowledge of it, except perhaps that it has a checklist and a set of activity cards. So what is Portage and where did it originate?

The Portage home-based model of early intervention was first developed in the USA around 1969. It takes its name from the small town of Portage, near Madison, Wisconsin. Over the years, it has been translated into many languages and spread its wings to over 100 countries. The UK, along with Japan, has one of the largest National Portage Associations.

The Portage home-based model is appropriate for babies and children who are experiencing difficulties with movement, language, play skills, daily living skills, problem-solving or learning skills, or children ‘at risk’ of developing difficulties in any one of the above areas.

Initially developed for parents, the model has been modified to reflect current research and best practice in early intervention, but it remains flexible and adaptable. From the onset, parents are emphasised as the decision makers, lifelong managers and advocates of their child. Today, however, when both parents may be out at work, it may not be a parent who carries out the activities—but a grandmother, childminder or other caregiver, within the home of the child or in the crèche.

Guiding principles of Portage
  • Parental involvement is critical to successful intervention.
  • Families know their child best and are important members of the early intervention team.
  • Parent–child interactions are the building blocks of a child’s development.
  • A child’s development is best supported through interactions with familiar people, in play and daily routines.
  • The Portage Home Visitor works with parents/families, who are central in deciding, planning and implementing the most appropriate programme for their child.
Programme planning

Child assessment for the purpose of programme planning has always been a strong component of the Portage Model, in many instances in conjunction with other developmental checklists and standardised assessments. However, within the model, assessment techniques such as parent interview, child observation and assessment data from other disciplines such as therapists, doctors, public health nurses are also employed to gather an accurate picture of the child.

The Portage Guide to Early Intervention consists of three parts: a checklist of behaviours, a set of activity cards and a manual of instructions. The checklist presents skills from birth to six years in the areas of infant stimulation, socialisation, self-help, language, motor and cognition. Each section is colour-coded and lists skills based on normal development.

Portage home visits

The Portage Model is dependent for its success on the partnership between the parent/caregiver and the home visitor, and their relationship based on building mutual trust and rapport. A parent–professional partnership is initiated in order to best meet the priorities and concerns of family and child. A visit once a week, fortnight or monthly is not enough for a child to learn a new skill. It is the parent who assures success by teaching their child during the week. The home visitor is very much an adult educator, rather than a child educator, as she will transfer her knowledge of the skill to be taught to the parent/caregiver who will in turn teach the child.

To ensure that the parent/caregiver carries through with the activity correctly, it is important that:

  • Parents are involved in planning appropriate goals,
  • The Portage home visitor observes the parent /caregiver demonstrating the activity,
  • The activity is written down so the parent/caregiver has a reference guide,
  • The activity is broken down into small steps,
  • Parent/caregiver may be required to record how well the child is carrying out the activity,
  • This process is repeated during each visit.

It is important to note that the Portage home visitor does not replace any member of a multidisciplinary team, but works in close cooperation with them—in many cases acting as a coordinator between the family and the multidisciplinary team.

Portage in Ireland

Many Irish staff have been trained in the Portage Model and a support group for Portage home visitors has been set up. Advanced workshops have been carried out by Mollie White (a founder member of the National Portage Association in the UK). We are hoping to repeat these workshops later this year, with additional workshops by David and Darlene Shearer of the International Portage Association USA. Introduction to the Portage Model comprises a three-day workshop. Parents/caregivers are welcome to attend.

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