Natia’s Story: Early Childhood Intervention in Georgia

Eastern Europe and Central Asia have the highest rates of institutionalized children in the world. For many, placement in an institution begins at birth.

When Natia gave birth to her son Cotne in Tbilisi, Georgia, two years ago, she was told he was very sick and “would be a vegetable.” The doctor recommended she put her baby in an institution. No one told her about any alternative support services.

“It was a very difficult time for me. My husband left me and I did not know what to do,” she says. “I was alone. I did not have any help, financially or emotionally.” She placed Cotne in the institution.

Eastern Europe and Central Asia have the highest rates of institutionalized children in the world. For many, placement in an institution begins at birth, especially if the child has a visible disability.

New mothers like Natia are often counselled shortly after birth by medical professionals to give up their infant to state care. Believing their child will be better off, and afraid of the alternative, many mothers agree.

A lack of community-based services, discriminatory attitudes by society—including medical professionals—and pressure from family members contribute to the relinquishment of children with disabilities.

Natia wanted to see Cotne, and began visiting him when he was six months old. “At first he did not move or react to anyone,” she says, “but later he started to react to me. When I would leave to go home, he always began crying and this motivated me to bring him home.”

It was difficult for Natia to get permission to take Cotne home. “I did not have any money. I was not working. I did not have any baby things.” The organization Children of Georgia stepped in and gave her the things she needed to take care of her son.

Becoming a parent for the first time is a major transition, one that brings difficulties in the best of circumstances. Most parents require support and reassurance during the earliest days and months as they adjust to parenthood and build a relationship with their baby.

When a child has a disability, these early attachments can be more difficult to form because of the child's medical requirements and difficulties with feeding. Most parents have not mentally prepared for the possibility of having a child with additional needs.

“At first I did not know what to do with Cotne,” Natia says, “but slowly I learned. The Children of Georgia specialist comes to my home. Cotne also goes to the rehabilitation center. I see what the specialists do, and I do this too. Things are better now.”

According to the Convention on the Rights of the Child, a child has a right to develop to "the maximum extent possible," the right to live with his or her parents when possible, and the right to care and support even when a disability is present. Early childhood intervention plays a critical role in ensuring these rights are realized.

Parents and professionals in the region are beginning to recognize the importance of early childhood intervention services, which ensure children remain with their families and participate in community life. Early childhood intervention is a system of coordinated supports that provide professional services to very young children with developmental delays and disabilities and their families. Professionals including speech therapists, physical and occupational therapists, and psychologists work with families to help them directly support their child.

Interventionists also help parents identify their own needs and available community supports to meet them. Parents learn how to interact with their children in ways that will support their child's development and make their interactions more enjoyable.

“My child teaches me how to be a good mother,” Natia says. “He teaches me how to fight for life. I used to be shy, but now I know how to struggle for life. What has really changed is that now I have hope for the future.”

Early childhood intervention services can now be found in many countries including Belarus, Bulgaria, Georgia, Russia, and Ukraine but much more work needs to be done. Natia’s story is a case in point.

With support from the Open Society Foundations, several organizations are working to develop early childhood intervention services and change societal attitudes around disability in Georgia. For more information, see the work of Children of Georgia, First Step Georgia, Georgian Portage Association, and the Georgian Association of Child Neurologists and Neurosurgeons.



Who ensures the safety of the infants when they are placed in a Government run facility? What laws protect these children from prostitution, neglect, medical experimentation? I do not understand the motivation of a Government that prefers to take children from their parents versus assisting the parents to enable them to raise their children.

Catherine, thank you very much for your comment and you have certainly raised some very important issues. We need not only legislation but mechanisms in place to ensure effective, transparent, and fair gatekeeping in order to redirect/connect children and families to other services and alternative care options whenever possible. For that to happen, community services need to be available and well-coordinated. Safeguarding and monitoring mechanisms must be in place. Every effort should be made to help make families aware of governmental and non-governmental services which are an alternative to relinquishment, for all children but especially when a child has complex care needs.

Thank you for this story. It's a quite actual problem in Eastern Europe. I have just returned from Israel, where I took participation in the very useful and informative course "Creative thinking in the field of special education." They reached a big progress in this field. I have just discussed it with some NGO in Georgia and we are eager to help children with special needs and their parents. As I found out they took as a model Scandinavian countries. Is their any chance to be more knowledgeable about their model of care for children with special needs?

Dear Keti, thank you for your comment. The course you describe sounds very interesting and I have heard from others that there are some good trainers in Israel. To find out more about service models in Scandinavian countries you might want to attend the 2016 International Society on Early Intervention conference http://depts.washington.ed /isei/2016conf_announce1.html

The European Agency for Special Needs and Inclusive Educations may also have some resources of interest to you though I think some are now outdated.

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