To describe a multi-disciplinary early screening and preventive intervention program for preschool boys within the Ultra-Orthodox sector and to highlight specific aspects of cultural adaptation.
Pediatric screening enables the prevention or early detection of diseases and developmental disturbances in childhood. Studies stress the importance of early intervention indicating the connection between early intervention and the prevention of future educational problems. Programs must be relevant to the cultural context of their target audience; Ultra-Orthodox Jews live apart, they value their separateness and ascribe sanctity to their lifestyle. The adaptation strategies of the screening and the preventive program to the Ultra-Orthodox community were based on principles of community partnership.
The program being described is a three-year program reaching approximately 400 children annually, and takes place in Ultra-Orthodox educational institutions. The program consists of two stages. First, all the children are screened; children displaying signs of developmental delay in motor and/or language skills are referred to professionals within the wider community. Second, preventive group interventions are provided to advance the skills of those children who, in the initial screening, displayed slight difficulties in specific skills.
The program was culturally adapted to preserve the child's Ultra-Orthodox identity. The program takes place in the child's natural environment, in Yiddish, under the close guidance of both a professional occupational therapist and a speech therapist, with Ultra-Othodox male teachers to provide the intervention.
Cultural factors such as language and gender separation influence the processes in a screening and intervention program for children in an isolated Ultra-Orthodox community. Health professionals from both within and outside the community need to take into consideration the cultural factors that facilitate the intervention.
Program adaptation must take these factors into account to assure cultural accessibility without the loss of therapeutic fidelity and efficacy