The issues arising from implementing an early intervention service, developed in the rural United States in the late 1960s in a range of different cultural contexts over a period of a quarter of a century, are explained. Services from India, Bangladesh, Jamaica and the United Kingdom are compared. As well as considering cross-cultural aspects of Portage, variability within one country, the United Kingdom, is considered by comparing one service in an inner-city area and one in a rural area.
PIP: In the late 1960s in rural Wisconsin, the Portage Guide to Early Intervention was developed to manage development delay in preschool children. A parent, usually the mother, teaches the child each day and keeps a record. A home visitor monitors progress weekly and teaches the parent by modelling the program with the child. It operates under basic assumptions, some of which many countries cannot meet. For example, services available in developed countries (e.g., health services) are not available in Bangladesh and India, because resources are limited and the population is so large. Further, there are considerable differences in culture between these countries and the West (e.g., extended family vs. nuclear family). Moreover, the major causes of developmental delay in these South Asian countries are different than in developed countries (birth asphyxia, malnutrition, and deficiency diseases vs. genetic causes). Professionals in India and Bangladesh have incorporated Portage into a variety of early intervention services, thereby modifying the model considerably. In Jamaica, however, professionals use the Portage model with only a few modifications. Fore example, they use it with all disabled children rather than just those with learning disabilities. A problem with using the model is the lack of manufactured toys and play materials listed in the curriculum. Jamaica has a training program for child development aides. Portage services exist throughout the UK. Urban programs serve many more immigrants from developing countries than do the rural programs. This requires modifying the Portage model. In all countries, costs pose a constraint. This overview of Portage services in various countries indicates that these services alone are relatively unimportant as direct agents of social change and may be an important element of broader social changes.