Examining the current practices of the individualized family services plan with young children with disabilities in Saudi Arabia

Abstract

Early intervention programs play an important role in supporting young children with disabilities and developmental disorders in acquiring various life skills before they reach school-going age. The present study aims to examine the current practices of the Individualized Family Service Plan (IFSP) for young children with disabilities in Saudi Arabia using a quantitative design. A sample of 212 early intervention providers—males (n = 35; 16.5%) and females (n = 177; 83.5%)—were surveyed. The IFSP questionnaire was based on Maryland State’s IFSP form. The order of the dimensions employed in the study from the highest to the lowest was as follows: initial data, the present level of the child’s development, permissions, early intervention services, information about the child and the family, and transition services. The findings of the study revealed that the current practices of the IFSP for young children with disabilities in Saudi Arabia were at the ‘often’ level.

Introduction

What is early intervention?

Early intervention is critical for children’s development, as it reduces impairments and delays from becoming complicated. Early intervention aims to increase the achievement of outcomes and enhance performance for both children and their families (Anderson et al. 2020, Kamal 2014, Ziviani et al. 2013). Early intervention services comprise an array of medical, health, educational, social, and psychological services that are provided to children with and without disabilities, or those at risk of developing disabilities, under the age of six. Arcobi (2018) asserted that the process and activities involved in early intervention programs must include comprehensive educational and developmental assessments, development of individualized educational plans, selection and adaptation of services, design of suitable learning strategies, psychological and counseling services, behavior modification, remedial language programs, and occupational and physical therapy. The interest in the education and rehabilitation of children with disabilities has been accompanied by a parallel interest in the provision of early intervention services to prevent mental, behavioral, and developmental problems that children with disabilities, or at-risk children, may have (Al-Jalamdah 2016, Al-Qarani and Bataynah 2007, Oueiss 2017). Being aware of their significance and effectiveness in early childhood programs, special education specialists and service providers began to place considerable emphasis on the early identification of and early intervention for children with disabilities to prevent developmental delays, the severity of disabilities, and the occurrence of secondary disabilities that may arise from delayed intervention. In this respect, Al-Qahtani (2016) indicated that the effectiveness of intervention diminishes because of the delay in identifying disabilities, as patterns of difficulties overlap, thereby making them difficult to diagnose and treat. Another study conducted by Ziviani et al. (2013) explored early intervention providers’ experiences in delivering services to children and their families. The results showed positive attitudes toward early intervention service quality and providing different kinds of support to children and families. The study also revealed the challenges that early intervention services providers encounter, such as insufficient funds and meeting the needs at high standards. The early intervention practices must be sober and reflect positive outcomes for children and families (Boyd et al. 2014).

Scientific and theoretical evidence reveals the significance of early intervention in early childhood. Development theories have documented a strong correlation between first years’ experiences and the level of learning in subsequent years. Provision of early intervention services is crucial owing to the sensitivity of children’s early years, which represent a critical period for at-risk children (Al-Qahtani 2016, Merzza 2005). Early intervention also has economic and social effects, as it makes it possible to help children benefit from their existing abilities, thereby reducing the enormous costs of special education and rehabilitation programs. It also increases children’s social effectiveness and facilitates their better inclusion in society, which would otherwise be difficult without the provision of early intervention services. Early intervention programs help children by shaping their traits, which enhances their ability to achieve their cognitive, kinetic, and language potential and become independent (Oueiss 2017).

Early intervention programs play an important role in supporting children with developmental disorders in acquiring various life skills before school-aging. In this respect, Arcobi (2018) reported the effectiveness of intervention programs in enhancing cognitive, language, kinetic, social, and emotional development in children with developmental disorders. Such programs proved effective in preparing children for inclusion in preschool and school programs.

The reality of early intervention in Saudi Arabia

There is worldwide interest in special education and individuals with disabilities; this is observed in Saudi Arabia as well, with the remarkable increase in the number of governmental and private centers and institutions that provide care for children with various disabilities and in different age groups (Merzza 2005). Official statistics suggest a noticeable rise in the number of children under the age of five who need early intervention services (Ministry of Health 2016). Over the past decade, there has been a significant increase in the efforts exerted in Saudi Arabia to provide integrated early intervention services to the families of children with disabilities. Baothman and Attamemi (2016) explored the satisfaction level of parents whose children received early intervention services. The results revealed a high level of satisfaction with early intervention services, especially social skills training for children. Parents reported that the intervention team showed respect, used simple language, kept the information of children and families private and confidential, and exhibited professionalism while dealing with and training children. By contrast, the level of satisfaction was low due to a lack of home visits, not getting detailed information about children’s conditions, lack of parents’ involvement in the decision-making process, they were not able to obtain assistance with accessing services such as hospitals and health centers, irregular reviews of children’s medical reports, and parents not trained to support their children’s development and meet their needs.

A study conducted by Al-Qahtani and Al-Hadedi (2008) documented the effectiveness of early intervention programs in Saudi Arabia. The study reported the emphasis placed on the provision of assessment and diagnosis services, which are essential for determining an appropriate educational placement for each child with a disability, developing educational and remedial programs, and determining appropriate teaching strategies. It was also found that valid and reliable assessment tools are available for effective use in the field. Moreover, role of the family as a dimension of effective early intervention programs came last. This can be attributed to families’ low awareness of the nature, importance, and approaches of early intervention. Other reasons could be the insufficiency of training and rehabilitation services offered to families and a lack of support and orientation programs targeting the needs of families of children with disabilities and at risk of developmental delay. Several studies have also reported that centers that provide early intervention services do not offer integrated services. For example, centers focused more on academic and social aspects and neglected family and health aspects (Abdulhamid 2018; Al-Rweili and Mahidat 2016).

Al-Qarani and Bataynah (2007) investigated the effectiveness of early intervention programs offered to children with hearing impairments in public and private institutions. The results revealed weaknesses in the medical services and services provided to families. The researchers concluded that early intervention programs in Arab countries did not reach the expected level in medical, familial, and educational dimensions, despite their significant role in the effectiveness of early intervention. The researchers therefore called for setting plans to promote the medical, familial, and educational aspects of early intervention in service centers. Obaydat (2014) evaluated early intervention services by exploring parents’ satisfaction with these services to promote their children with autism and improve their quality of life. The parents’ satisfaction ranged from high to average. For example, satisfaction was high regarding collaboration between families and specialists, whereas it was average regarding services provided to children and families. Another study conducted by Kamal (2014) explored parents’ perceptions of early intervention services in Saudi Arabia and Egypt. The results showed that there was a low level of perception and insufficient early intervention services provided to parents and their children with disabilities.

Considerable efforts have been made in Saudi Arabia in the field of early intervention. However, these efforts are no more than individual endeavors lacking comprehensiveness and purpose when compared to the countries that are leading in the provision of early intervention services. This can be due to several reasons. First, a lack of global early intervention programs in local centers. Second, early intervention services are insufficient in terms of providing services for both children and families. Third, absence of work teams where coordinated roles of individuals are well-defined negatively affects the provision of quality early intervention services. Fourth, work teams are not concerned with identifying the early intervention needs and preferences of families of children with disabilities. Fifth, the number of centers providing comprehensive rehabilitation services is less than required. Lastly, early intervention programs are not developed professionally; hence, the effectiveness of these intervention programs suffers (Al-Qahtani 2016, Merzza 2005).

The individual family service plan (IFSP) in Saudi Arabia

The IFSP concept

The IFSP is a document written to guarantee the right of young children with disabilities to obtain all rehabilitative, training, and educational services (Ministry of Education 2018).

The contents of the IFSP

The content of the IFSP is divided into two sections (Ministry of Education 2018), as follows:

Initial data: These include the child’s name, date of birth, mother’s name, address, phone, cell phone, email, kindergarten’s name, the name of the special education teacher, the name of the list coordinating services, determining the start and end date of services, and the dates for the periodic and annual plan review.

Elements of the IFSP: (1) The child’s current level of development: A comprehensive and accurate description of the child’s current growth level of strengths and needs in the cognitive, adaptive, healthy, sensory, motor, linguistic, social/emotional domain; (2) Family data and information: Data intended to be collected and documented, such as family interests, needs, priorities, strengths, and sources of help and support available for the child and family; (3) Long/short term goals: Goals related to meeting the child’s needs for developmental and functional aspects, which are determined based on the information obtained from the evaluation process for the child and on the family information that has been described. The selected goals are arranged according to priority and are formulated in a procedural manner that is observable and measurable; (4) Educational environment: Specifications of the environment in which the services will be provided, as it must be closer to the natural environment of the child and family; (5) Necessary and appropriate services and their schedule of provision: A statement of the services that will be provided to the child and his family, the methods of providing them, and the place of their provision in proportion to the needs of the child. The priorities of the family, in addition to specifying the number of times each service is provided to the child and family. The time period for each session and the person responsible for providing each service must be determined; (6) Determine the participants in the plan’s activities in preparation, implementation, evaluation, and follow-up (Ministry of Education 2018).

Requirements for preparing and implementing the plan

Preparation of the plan: There are several conditions to prepare the IFSP. The plan must be prepared with the participation of all members of the work team within a period not exceeding 10 days from the end of the evaluation procedures. The plan must be prepared based on the results of the measurement and evaluation, the priorities of the family and the child, and the participation of the family (Ministry of Education 2018).

Implementation of the plan: There are several conditions for implementing the IFSP. The implementation of the plan must start within a period not exceeding one week of its preparation, and it must be implemented by everyone involved in providing the service stipulated in the plan. There must be coordination between the members in charge of implementing the plan and the special education teacher (early intervention) supervises the implementation of the plan. The services and facilities should be adapted according to the needs of children, and the principle of flexibility prevails in all types of services provided. Intervention services should be designed so that they are an essential part of the activities of the daily life of the child and his or her family, and early intervention services should be designed to prevent the child from developing future problems or disabilities. Lastly, the family carries out the plan (Ministry of Education 2018).

Transition services

This is a set of organized procedures included in the IFSP, which is provided to the child to accommodate changes in services and the work team that provides these services when moving from one program to another or from one environment to another (Ministry of Education 2017).

The components of a transition plan are as follows: (1) family participation in the relocation process, (2) discussing the child’s readiness for the transition process, (3) the child’s comprehensive evaluation information, (4) discussing and documenting the options that are discussed with the family, and (5) eligibility status for special education services (Ministry of Education 2017).

Transition plan steps: There are several steps to follow within the IFSP: (1) forming a working group for the transition phase, (2) scheduling meetings between the team, (3) determining the basic requirements for the transition process, (4) determining the important dates as referrals, (5) defining effective communication procedures and methods, (6) encouraging family visits in preparation for the new educational environments, (7) determining the needs of the child in the new educational environments, (8) providing counseling services for the family, (9) conducting follow-up and evaluation of activities and procedures of the transition phase (Ministry of Education 2017).

Although previous efforts have provided important insights into the use of early intervention services in Saudi Arabia, there is a lack of a comprehensive description of the IFSP for young children with disabilities. Further, formal regulations or laws and policy information about the IFSP is limited.

Literature review

The Individuals with Disabilities Education Act Part C (IDEA 2004) qualifies children with disabilities or at risk of developing disabilities from birth up to 3 years of age and their families to receive free early intervention services. Under part C of the IDEA (2004), each child with a disability is entitled to a team-developed plan—the Individualized Family Service Plan (IFSP)—which is mandated to be implemented within 45 days of referral. The team includes family members of infants and toddlers with disabilities and professionals from various disciplines (Pretti-Frontczak and Bricker 2000).

According to Dunst (2007), early intervention services are defined as ‘experiences and opportunities afforded to infants and toddlers with disabilities by the children’s parents and other primary caregivers that are intended to promote the children’s acquisition and use of behavioral competencies to shape and influence their prosocial interactions with people’ (p. 162). Early intervention services may vary depending on the children’s and their family’s needs, for example, physical therapy, occupational therapy (Aaron et al. 2014), or services of speech-language pathologists (Polmanteer and Turbiville 2000).

The IDEA (2004) requires a family-centered approach to services and support delivery in the child’s natural environment. Family-centered practices can be defined as ‘an approach to working with families that honors and respects their values and choices and which includes the provision of supports necessary to strengthen family functioning’ (Dunst 2007, p. 370). These services and supports must be developed on the basis of the child’s and the family’s needs, concerns, and priorities (Bailey et al. 1992, Bricker 2001, Zhang et al. 1999). As mentioned by several studies, a family-centered intervention is vital in enhancing parents’ capacity to support their child’s development (Adams and Tapia 2013, Schertz et al. 2011).

The legislation requires families and professionals to collaborate in developing and delivering a service plan that serves both infants and toddlers with disabilities and their families (Byington and Whitby 2011, IDEA 2004, Polmanteer and Turbiville 2000). Families of children with disabilities and professionals collaborate as equal partners in designing a plan and setting goals, and contribute to decisions on service delivery (Byington and Whitby 2011). Parents are encouraged to attend the IFSP meetings, participate in developing the IFSP, set goals and services, and contribute to the decision-making process (McWilliam et al. 1998, Pang 2011). The IFSP team members should provide opportunities to the families of children with disabilities to express their needs, concerns, and priorities to develop goals and services that promote the child’s development (Ridgley and Hallam 2006, Trivette and Dunst 2000).

According to Göncü and Nc (1999), everyday activities in the cultural milieu promote the growth and development of a child. A number of studies have examined the natural learning opportunities that arise from random, everyday activities (Dunst 2007, Jung and Baird 2003). Although both children with and without disabilities regularly engage and participate in different kinds of family and community activities (Dunst and Bruder 1999, Dunst et al. 2002), children with disabilities seem to engage in fewer activities. This may be because of the nature of the disability and the parents’ beliefs about learning and development (Trivette et al. 2004). Nevertheless, it is a well-known fact that these activities have a significant influence on children’s behavior and overall development (Raab and Dunst 2007).

The basic goals of IFSPs are to increase legal accountability, parents’ involvement, and individuals’ independence, freedom, and individualism (Gallagher and Desimone 1995, Pang 2011). A study conducted by Gallagher (1998) examined the goals statements of the IFSPs of 72 families from three different states: Colorado, North Carolina, and Pennsylvania. The findings showed that the major focus of the goals was on the child, despite the plan having a family-focused approach. The study recommended more training for service providers. Several studies have shown the positive effects of the family role on early intervention programs, including actual increases in their knowledge and child development, satisfactory practices, and confidence (Barlow and Coren 2018, Barlow et al. 2012).

The IFSP document should be written in simple language, reflect the needs of infants and toddlers with disabilities and their families, and suggest professional solutions for those needs (McWilliam et al. 1998). The IFSP outlines the support services that children with disabilities and their families will receive. It can rightly be described as ‘a blueprint,’ ‘a road map,’ or ‘guidelines’ for families and the IFSP team to manage the development, implications, and evaluation of early intervention services and supports (Deal et al. 1989, Gatmaitan and Brown 2016, Jung et al. 2015, Ridgley et al. 2011).

The IFSP forms vary from state to state but all of them contain the required components (Jung 2010). However, the federal legislation requires states to include certain components when developing the IFSP. Each state has its own IFSP format that meets the federally required components (Jung 2010, Jung et al. 2015). The IFSPs include: (1) statement of the child’s present level of functioning, (2) family’s priorities, needs, concerns, resources, and strengths, (3) statement of the natural environment in which early intervention services will be provided, (4) outcomes for the child and the family, (5) projected date, length, duration, and frequency of services for the children and their families, and (6) child’s transition services (34 CFR § 303.344). To ensure that goals are developed and services arranged to meet the needs of children with disabilities and their families, the IFSP is reviewed every six months and updated annually (Center for Parent Information and Resources 2017).

A good IFSP has some indicators; for example, the goals should be functional and related to the priorities and needs of the intended recipients of the services (Ridgley et al. 2011). The goals, strategies, and services are designed to meet these needs as much as possible in a child’s natural environment (Pang 2011). Developing goals linked with the child and his/her family’s needs, priorities, and resources is critical to determining the type and quality of early intervention services and supports (Pang 2011). A number of studies noted that most IFSPs contain these necessary components (Bradley et al. 2007, Jung and Baird 2003).

There is clear evidence of the importance of early intervention services for young children with disabilities in improving the areas of cognitive, behavioral, social, and health development, especially the modernity of these services in Saudi Arabia (Merzza 2014). Due to the shortage of the number of studies that deal with early intervention services according to the individualized family services plan, this study is considered one of the first to address the gap of knowledge in the services provided in the early years of development of children with disabilities in Saudi Arabia. The purpose of the current study was to examine the current practices of the IFSP with young children with disabilities in Saudi Arabia. The specific study questions addressed were: (1) What are the current practices of IFSPs for young children with disabilities in Saudi Arabia? (2) Are there any significant differences among the independent variables (early intervention providers’ major, type of institution, number of courses in the IFSP, type of disability/disorder and geographic region), and the dependent variable (questionnaire items)?

Materials and methods

Participants

Participants in this study included 212 early intervention providers, males (n = 35; 16.5%) and females (n = 177; 83.5%), who worked at general and special schools, centers, and instantiations throughout Saudi Arabia—a study of all regions is of great value, especially when examining and exploring a practice. Participants were categorized according to their experience in the field of early intervention: less than five years (n = 104; 49.1%), from six to 10 years (n = 51; 24.1%), and more than 11 years (n = 57; 26.9%). They had different qualifications: diploma (n = 14; 6.6%), bachelor’s degree (n = 173; 81.6%), master’s degree (n = 22; 10.4%), and PhD degree (n = 3; 1.4%). For the children who were taught, boys (n = 107; 50.5%), girls (n = 64; 30.2%), and boys and girls combined (n = 41; 19.3%).

The participants majored in the following: special education (n = 122; 57.5%); applied medical sciences (n = 24; 11.3%); psychology (n = 28; 13.2%); social services (n = 7; 3.3%); and other disciplines (n = 3; 14.6%). For the type of educational institution, the categories were special education centers (n = 157; 74.1%); special education schools (n = 19; 9%); integrated kindergartens (n = 5; 2.4%); and others (n = 31; 14.6%). According to the training courses provided in the field of early intervention, the participants were categorized as follows: no courses (n = 87; 41%); one to three courses (n = 82; 38.7%); four to seven courses (n = 21; 9.9%); and eight courses or more (n = 22; 10.4%). The distribution according to the type of disability was as follows: intellectual disability (n = 77; 36.3%); hearing impairments (n = 7; 3.3%); visual impairments (n = 1; 0.5%); autism (n = 17; 8%); learning disabilities (n = 32; 15.1%); attention deficit and hyperactivity disorders (n = 4; 1.9%); multiple disabilities: (n = 18; 8.5%); and other disabilities (n = 56; 26.4%). Categorization according to region was as follows: central region (n = 112; 52.8%); western region (n = 20; 9.4%); eastern region (n = 8; 3.8%); northern region (n = 25; 11.8%); and southern region (n = 47; 22.2%). Table 1 shows the distribution of participants according to variables.

Table 1.

Distribution of participants according to variables.

Variable	Levels	Frequency	Percentage
Gender	Male	35	16.5%
	Female	177	83.5%
Experience	Less than five years	104	49.1%
	Six to 10 years	51	24.1%
	More than 11 years	57	26.9%
Qualifications	Diploma	14	6.6%
	Bachelor’s degree	173	81.6%
	Master’s degree	22	10.4%
	PhD degree	3	1.4%
Major	Special education	122	57.5%
	Applied medical sciences	24	11.3%
	Psychology	28	13.2%
	Social services	7	3.3%
	Other disciplines	3	14.6%
Children who being taught	Boys	107	50.5%
	Girls	64	30.2%
	Boys & girls combined	41	19.3%
Educational institution	Special education centers	157	74.1%
	Special education schools	19	9%
	Integrated kindergartens	5	2.4%
	Others	31	14.6%
Training courses	No courses	87	41%
	One to three courses	82	38.7%
	Four to seven courses	21	9.9%
	Eight courses or more	22	10.4%
Type of disability	Intellectual disability	77	36.3%
	Hearing impairments	7	3.3%
	Visual impairments	1	0.5%
	Autism	17	8%
	Learning disabilities	32	15.1%
	Attention deficit and hyperactivity disorders	4	1.9%
	Multiple disabilities	18	8.5%
	Other disabilities	56	26.4%
Region	Central region	112	52.8%
	Western region	20	9.4%
	Eastern region	8	3.8%
	Northern region	25	11.8%
	Southern region	47	22.2%

Instrument

The Maryland State Department of Education (MSDE) (2018) offers IFSP form online in a number of languages, including Arabic. We used the official Arabic version provided by MSDE as a guide in developing IFSP questionnaire. The accuracy of the translation of Maryland’s IFSP Arabic version was reviewed by three translators who were fluent in both languages Arabic and English with experience in special education topics. Maryland’s IFSP has been chosen among other plans because it contains comprehensive and integrated information about early intervention services for young children with disabilities as well as its availability in the online Arabic version, which helped in adapting, amending, and evaluating the plan to fit a Saudi cultural context.

In Saudi Arabia, early intervention services are provided to children at risk of developmental delays and children with disabilities from birth to six years old and their families. These services include such as early intervention, special education, general health, psychological services, family services, and social services. These services can be provided at special education services center or pre-school settings usually for 0-6 years old (The Ministry of Education 2016). Because the field of early intervention is relatively recent in Saudi Arabia, and the lack of a clear law refuting the appropriate ages for the provision of early intervention services, these services are provided at an early age under the age of six, taking into account the transition stages from the age of three years to the preschool stage. The Saudi early intervention providers use the IFSP and Individualized Education Program (IEP) with young children with disabilities under the age of six years and these are considered as early intervention services that provided in early stage of children’s developmental delay. Therefore, the questionnaire was built taking into account this slight difference in the mechanism of providing early intervention services for young children with disabilities.

To measure the accuracy of Maryland’s IFSP for use in a Saudi cultural context, the IFSP questionnaire was developed based on Maryland’s IFSP form. The questionnaire contained two parts. The first part was related to participants’ demographics (gender, education degree, major, type of institution that provided services, experience, and training workshops, type of disability, and region). The second part was related to the IFSP. The statements derived from Maryland’s IFSP form were categorized into six domains: (1) initial data; (2) information about the child and their family; (3) present level of the child’s development; (4) early intervention services; (5) transition services; and (6) permissions. The participants were asked to rate their degree of agreement with the statements on a five-item Likert scale (1 = never to 5 = always). The questionnaire was reviewed by six special education faculty members in Saudi Arabia, and their feedback, comments, and recommendations were considered in improving the questionnaire.

To determine the validity of the questionnaire, the researchers conducted a correlation coefficient test between the questionnaire’s items and the dimensions to assess correlations between each item and its subscale. All correlations of the questionnaire items with their dimensions were significant at the level of 0.01, which indicates the validity of the items. The correlations of the dimensions with each other and with overall questionnaire scores were significant at the level of 0.01, which indicates the validity of the questionnaire and its dimensions.

For the reliability of the questionnaire, Cronbach’s alpha internal consistency coefficient, was calculated. Cronbach’s α of the questionnaire total score was 0.973, signifying a high degree of reliability. Reliability based on the split-half method which is another subtype of internal consistency reliability was done by formula of Spearman-Brown, value was 0.86, and by Guttmann formula, value was 0.86, which indicate a high degree of reliability. Cronbach’s α for questionnaire dimensions ranged from 0.860 to 0.939, and all these statistics were generated using Statistical Package for the Social Sciences (SPSS, version 24) program.

Data collection and procedures

Research ethics were considered in the current study. We obtained official approval from the Deanship of Scientific Research at King Saud University and the Ministry of Education in Saudi Arabia. The sample consisted of early intervention providers in various centers and institutes of special education in the Saudi Arabia. We made a list of all centers, institutes, and agencies that provided intervention services for young children with disabilities and arranged them according to their location. This list included the central region, the western and eastern region, and the north and the south region. The questionnaire was distributed to a sample of early intervention providers, who were randomly chosen. The participants were informed that their participation was voluntary and that their responses would be kept confidential and private and would be used only for research purposes. A total of 300 questionnaires were distributed to early intervention providers who worked for the Ministry of Education in all regions of Saudi Arabia. A total of 212 questionnaires were completed.

Data analysis

The data were statistically analyzed using the Statistical Package for the Social Sciences (SPSS) program. For the first question, frequency, percentages, means, and standard deviations were used to describe the sample. One-way analysis of variance (ANOVA) was conducted to determine the differences between the study groups; the Scheffe and least significant differences (LSD) tests were also used for post-hoc multiple comparisons for the second question. The Pearson correlation coefficient method was used to ascertain the validity of the questionnaire. Cronbach’s alpha coefficient and the split-half procedure were employed with the Spearman-Brown equation and the Guttmann equation to find the reliability of the study instrument. To verify the normal distribution of the dataset of the total degrees of the questionnaire, and that it follows the normal distribution, we conducted the Kolmogorov-Smirnov test and the Shapiro-Wilk test. The Kolmogorov-Smirnov statistic reached (0.048), with a significance level (0.200), while the Shapiro-Wilk statistic reached (0.991) with a significance level (0.219); thus, the null hypothesis was accepted, which was that the data were subject to a normal distribution.

Results

Results of the first research question: what are the current practices of IFSPs for young children with disabilities in Saudi Arabia?

To address this question, the mean scores and standard deviations of all the questionnaire dimensions were calculated. Scores ranged from 1–1.80 to 4.24–5, that is, from ‘never’ to ‘always.’ Mean scores of the dimensions ranged between 3.59 and 4.13. The total mean score was 3.80, falling in the ‘often’ category. Thus, the results revealed that early intervention services of current practices of IFSPs are often provided to young children with disabilities in Saudi Arabia. Table 2 shows the means, standard deviations, and order of dimensions of the IFSP questionnaire.

Table 2.

Means, standard deviations, and order of dimensions of the IFSP components questionnaire.

	Item no.	Item	N	Mean	SD	Order	Explanation
Initial Data	1	General information about the child is available (date of birth, ID, civil registry, etc.)	212	4.67	.776	1	always
	2	General information about the child’s family is available (address, contact method, contact addresses, etc.)	212	4.49	.900	2	always
	3	Information is available about the service coordinator	212	4.13	1.148	9	often
	4	Individual family plan team member information (names and specializations) is available	212	4.14	1.147	7.5	often
	5	Information on the child’s general health (age, weight, vaccinations) is available.	212	4.38	1.662	3	always
	6	Information on the child’s medical examinations (nutrition, name of the specialist doctor) is available	212	3.87	1.197	16.5	often
	7	Information is available on medical concerns of the family	212	3.52	1.248	34	often
	8	Information on aspects of development is available (cognitive, communicative, social/emotional, adaptive, physical and includes: ‘small and large’ motor skills, hearing and vision)	212	4.14	1.034	7.5	often
	9	Information is available regarding a child’s eligibility for an individualized family plan (25% delayed development, or abnormal growth leading to a delay in the child’s development)	212	3.80	1.247	23.5	often
Total mean for dimension 1			212	4.13	0.91	1	often
Information about the child and the family	1	Information on assessment methods for child and family (interview/scale) is available	212	4.09	1.160	10	often
	2	Information on routine daily activities (time to wake up, get dressed, play, etc.)	212	3.45	1.296	36.5	often
	3	Basic information for the evaluation is available (evaluation history, detailed information on family answers)	212	3.99	1.129	12	often
	4	Information about family resources (people, activities, programs, organizations) is available.	212	3.47	1.275	35	often
	5	Information about family priorities is available (the most important needs of the child, family desires, the child’s strengths and interests)	212	3.84	1.200	19	often
	6	Information is available about family concerns (matters causing family anxiety)	212	3.62	1.269	31	often
	7	There is information about community relations that the family would like additional information such as child care, housing assistance, and support networks.	212	3.26	1.385	39	sometimes
Total mean for dimension 2			212	3.67	1.01	5	Often
Present level of child’s development	1	A summary of the child’s current developmental level is provided in the five basic aspects (cognitive, communication, social/emotional, adaptation, physical and includes: ‘fine and large’ motor skills, hearing and vision)	212	4.17	1.071	5	often
	2	Information on the history of the various assessments is available	212	4.01	1.156	11	often
	3	A growth matrix is available to compare the child’s development with his peers (social skills, acquisition and use of knowledge and skills, demonstrating appropriate behaviors to meet needs)	212	3.63	1.294	29.5	often
	4	Results for the family and the child are available in what the family wants to achieve	212	3.57	1.254	33	often
	5	Strategies that apply with the family and the child are available	212	3.75	1.291	26	often
	6	History of assessments is available in the results	212	4.16	1.127	6	often
Total mean for dimension 3			212	3.88	1.00	2	Often
Early intervention services	1	Information is available about ways to support a child’s education and development	212	3.87	1.167	16.5	often
	2	Information about family support is available	212	3.67	1.162	28	often
	3	Information is available on the early intervention services provided and their types	212	3.78	1.172	25	often
	4	Information on early intervention service providers (name and specialty) is available.	212	3.95	1.217	13	often
	5	Information is available about the early intervention services coordinator	212	3.81	1.263	22	often
	6	Information is available about the provision, location and duration of the service	212	3.92	1.193	14	often
	7	Family contact information is available	212	4.30	1.009	4	always
	8	Information about providing the service in the natural environment is provided whenever possible	212	3.74	1.279	27	often
	9	Information is provided explaining the reasons for not providing the service in the natural environment	212	3.41	1.312	38	sometimes
	10	Providing special services for the blind and deaf	212	2.54	1.506	41	rarely
Total mean for dimension 4			212	3.70	0.90	4	Often
Transition services	1	Information on informal transportation available (hospital-to-home transportation, new caregiver)	212	2.98	1.328	40	sometimes
	2	Information on transition (transition from early intervention or transition to another program in the community or school) is available	212	3.58	1.230	32	often
	3	Information about a child’s eligibility to receive preschool special education services is available	212	3.86	1.200	18	often
	4	Information about the outcome of the meeting with the child’s family to determine eligibility is available	212	3.83	1.218	20	often
	5	Information on community services is available	212	3.63	1.298	29.5	often
Total mean for dimension 5			212	3.59	1.02	6	Often
Permissions	1	There is an option to continue or end individual family services plan for the family	212	3.80	1.196	23.5	often
	2	Information is available about what services are guaranteed by laws and regulations	212	3.45	1.296	36.5	often
	3	Required family and dates signatures are available	212	3.90	1.227	15	often
	4	A written notification form is available to the family	212	3.82	1.317	21	often
Total mean for dimension 6			212	3.74	1.02	3	Often
Total mean			212	3.80	0.84	Often

Results of the second research question: are there any significant differences among the independent variables (early intervention providers’ major, type of institution, number of courses in IFSP, type of disability/disorder and geographic region) and the dependent variable (questionnaire items)?

Differences in the IFSP practices based on early intervention providers’ majors

An ANOVA test was conducted to explore differences in the current practices of the IFSP by early intervention providers’ major. These results are shown in Table 3.

Table 3.

ANOVA for differences in the current practices of the IFSP by early intervention providers’ majors.

Dimensions		Sum of squares	df	Mean square	F	Sig.
Initial data	Between groups	842.225	4	210.556	3.258	.013
	Within groups	13377.530	207	64.626
	Total	14219.755	211
Information about the child and the family	Between groups	309.701	4	77.425	1.568	.184
	Within groups	10220.431	207	49.374
	Total	10530.132	211
Present level of child’s development	Between groups	163.953	4	40.988	1.134	.342
	Within groups	7485.066	207	36.160
	Total	7649.019	211
Early intervention services	Between groups	859.338	4	214.835	2.728	.030
	Within groups	16301.619	207	78.752
	Total	17160.958	211
Transition services	Between groups	206.382	4	51.596	1.947	.104
	Within groups	5486.122	207	26.503
	Total	5692.505	211
Permissions	Between groups	81.298	4	20.324	1.223	.302
	Within groups	3439.471	207	16.616
	Total	3520.769	211
Total	Between groups	10092.016	4	2523.004	2.159	.075
	Within groups	241898.979	207	1168.594
	Total	251990.995	211

It is clear from Table 3 that there were differences in the dimensions of initial data and early intervention providers’ academic major. To identify the direction of these differences, we used the LSD test for post-analysis. Significant differences in the initial data dimension were found between (1) social services major and special education major, in favor of social services major (MD = 10.848; p = 0.001); (2) social services major and applied medical science major, in favor of social services major (MD = 8.560; p = 0.014); (3) social services major and psychology major, in favor of social services major (MD = 10.321; p = 0.003); and (4) social services major and other major, in favor of social services major (MD = 9.756; p = 0.004). No significant differences were found among other academic majors. This result indicates that social services major had statistically significant higher influence in the initial data dimension than did all other majors.

Regarding the early intervention services dimension, significant differences were found between: (1) applied medical science major and special education major, in favor of applied medical science major (MD = 4.808; p = 0.016); (2) applied medical science major and psychology major, in favor of applied medical science major (MD = 5.292; p = 0.033); and (3) applied medical science major and other majors, in favor of applied medical science major (MD = 6.130; p = 0.012). This result revealed that a degree in applied medical science had a statistically significant higher influence in early intervention than other majors except social services major. Social services major scored significantly higher than other majors (MD = 7.839; p = 0.036).

Differences in the IFSP practices based on type of institution providing the service

An ANOVA test was conducted to explore differences in the current practices of the IFSP by type of institution providing the service. These results are shown in Table 4.

Table 4.

ANOVA for differences in the current practices of the IFSP by type of institution providing the service.

Dimensions		Sum of Squares	df	Mean Square	F	Sig.
Initial data	Between groups	909.059	3	303.020	4.735	.003
	Within groups	13310.696	208	63.994
	Total	14219.755	211
Information about the child and the family	Between groups	843.476	3	281.159	6.037	.001
	Within groups	9686.656	208	46.570
	Total	10530.132	211
Present level of child’s development	Between groups	1149.221	3	383.074	12.259	.000
	Within groups	6499.798	208	31.249
	Total	7649.019	211
Early intervention services	Between groups	1820.666	3	606.889	8.229	.000
	Within groups	15340.291	208	73.751
	Total	17160.958	211
Transition services	Between groups	598.228	3	199.409	8.142	.000
	Within groups	5094.277	208	24.492
	Total	5692.505	211
Permissions	Between groups	398.187	3	132.729	8.841	.000
	Within groups	3122.581	208	15.012
	Total	3520.769	211
Total	Between groups	31839.143	3	10613.048	10.027	.000
	Within groups	220151.852	208	1058.422
	Total	251990.995	211

Based on Table 4, there were differences among the dimensions and the total score. To identify the direction of differences, the researchers used the Scheffe test for post-analysis; results were as follows:

There was significant difference found in the availability of initial data between special education centers and special education schools, in favor special education centers (MD = 7.194; p = 0.004). This result indicated that special education centers were statistically higher in initial data dimension than special education schools. A statistically significant differences in available information about the child and the family were found between (1) special education centers and special education schools, in favor of special education centers (MD = 6.970; p = 0.001) and (2) other institutions and special education schools, in favor of other institutions (MD = 6.409; p = 0.017).

In the present level of the child’s development dimension, differences were statistically significant between (1) special education centers and special education schools, in favor of special education centers (MD = 8.146; p = 0.000); (2) preschool-inclusion and special education schools, in favor of special education schools (MD = 9.400; p = 0.012); and (3) other institutions and special education schools, in favor of other institutions (MD = 7.032; p = 0.000). For the early intervention services dimension, differences were statistically significant between: (1) special education centers and special education schools, in favor of special education centers (MD = 10.319; p = 0.000) and (2) other institutions and special education schools, in favor of other institutions (MD = 8.888; p = 0.006).

In the transition services dimension, differences were statistically significant between (1) special education centers and special education schools (MD = 5.891; p = 0.000) and (2) other institutions and special education schools, in favor of other institutions (MD = 8.888; p = 0.016). For the last dimension, permissions, differences were statistically significant between (1) special education centers and special education schools (MD = 4.771; p = 0.000) and (2) other institutions and special education schools, in favor of other institutions (MD = 3.630; p = 0.018).

In the questionnaire total score, differences were statistically significant between (1) special education centers and special education schools (MD = 43.292; p = 0.000) and (2) other institutions and special education schools, in favor of other institutions (MD = 36.949; p = 0.002).

Differences in the IFSP practices based on number of courses taken by providers

The ANOVA test was conducted to explore the current practices of the IFSP by the number of courses in the IFSP. These results are presented in Table 5.

Table 5.

ANOVA for differences in the current practices of the IFSP based on number of courses taken by the providers.

Dimensions		Sum of Squares	df	Mean Square	F	Sig.
Initial data	Between groups	352.492	3	117.497	1.762	.155
	Within groups	13867.263	208	66.670
	Total	14219.755	211
Information about the child and the family	Between groups	368.894	3	122.965	2.517	.059
	Within groups	10161.238	208	48.852
	Total	10530.132	211
Present level of child’s development	Between groups	56.236	3	18.745	.514	.673
	Within groups	7592.783	208	36.504
	Total	7649.019	211
Early intervention services	Between groups	268.023	3	89.341	1.100	.350
	Within groups	16892.934	208	81.216
	Total	17160.958	211
Transition services	Between groups	213.646	3	71.215	2.704	.047
	Within groups	5478.858	208	26.341
	Total	5692.505	211
Permissions	Between groups	77.362	3	25.787	1.558	.201
	Within groups	3443.407	208	16.555
	Total	3520.769	211
Total	Between groups	6925.587	3	2308.529	1.959	.121
	Within groups	245065.409	208	1178.199
	Total	251990.995	211

Table 5 shows that there were differences in the transition services dimension. To identify the direction of these differences, the LSD test was used for post-analysis; results are as follows:

There were statistically significant differences between (1) service providers who had 1–3 courses and those who had none, in favor of those with 1–3 courses (MD = .975; p = 0.013) and (2) service providers who offered 4–7 courses and those who offered none in favor of those with 4–7 courses (MD = 2.540; p = 0.043).

Differences in the IFSP practices based on the types of disability/disorder

To find differences in the current practices of the IFSP by type of disability/disorder, the ANOVA test was conducted. The results are shown in Table 6.

Table 6.

ANOVA for differences in the current practices of the IFSP based on type of disability/disorder.

Dimensions		Sum of Squares	df	Mean Square	F	Sig.
Initial data	Between groups	1454.282	6	242.380	3.892	.001
	Within groups	12765.473	205	62.271
	Total	14219.755	211
Information about the child and the family	Between groups	1015.006	6	169.168	3.645	.002
	Within groups	9515.126	205	46.415
	Total	10530.132	211
Present level of child’s development	Between groups	638.556	6	106.426	3.112	.006
	Within groups	7010.463	205	34.197
	Total	7649.019	211
Early intervention services	Between groups	1212.224	6	202.037	2.597	.019
	Within groups	15948.734	205	77.799
	Total	17160.958	211
Transition services	Between groups	591.322	6	98.554	3.961	.001
	Within groups	5101.183	205	24.884
	Total	5692.505	211
Permissions	Between groups	316.416	6	52.736	3.374	.003
	Within groups	3204.353	205	15.631
	Total	3520.769	211
Total	Between groups	27717.296	6	4619.549	4.223	.000
	Within groups	224273.700	205	1094.018
	Total	251990.995	211

Table 6 shows there were differences among the groups in all the dimensions and the total score. The LSD test was used for post-analysis to determine the direction of these differences; results are as follows:

For the initial data dimension, there were statistically significant differences between: (1) intellectual disability and hearing disability, in favor of intellectual disability (MD = 7.195; p = 0.022); (2) intellectual disability and autism, in favor of intellectual disability (MD = 5.674; p = 0.008); (3) intellectual disability and learning disabilities, in favor of intellectual disability (MD = 6.815; p = 0.000); and (4) intellectual disability and other disabilities, in favor of intellectual disability (MD = 2.784; p = 0.046). There were also statistically significant differences in the initial data dimension between multiple disabilities and learning disabilities in favor of multiple disabilities (MD = 4.031; p = 0.022).

In the information about the child and the family dimension, the differences were statistically significant between:(1) intellectual disability and hearing disability, in favor of intellectual disability (MD = 8.195; p = 0.003); (2) intellectual disability and autism, in favor of intellectual disability (MD = 4.178; p = 0.023); (3) intellectual disability and learning disabilities in favor of intellectual disability (MD = 4.766; p = 0.001); (4) multiple disabilities and hearing disability, in favor of multiple disabilities (MD = 8.373; p = 0.006); (5) multiple disabilities and learning disabilities, in favor of multiple disabilities (MD = 4.944; p = 0.015); and (6) multiple disabilities and hearing disability, in favor of multiple disabilities (MD = 5.536; p = 0.044).

For the present level of the child’s development dimension, the differences were statistically significant between:(1) intellectual disability and autism, in favor of intellectual disability (MD = 5.438; p = 0.001); (2) intellectual disability and learning disabilities, in favor of intellectual disability (MD = 3.776; p = 0.002); (3) multiple disabilities and autism, in favor of multiple disabilities (MD = 4.134; p = 0.038); and (4) multiple disabilities and autism, in favor of multiple disabilities (MD = 3.805; p = 0.020).

In the early intervention services dimension, the differences were statistically significant between:(1) intellectual disability and hearing disability, in favor of intellectual disability (MD = 7.805; p = 0.026); (2) intellectual disability and autism, in favor of intellectual disability (MD = 5.578; p = 0.019); (3) intellectual disability and learning disabilities, in favor of intellectual disability (MD = 5.457; p = 0.004); (4) intellectual disability and multiple disabilities, in favor of intellectual disability (MD = 3.162; p = 0.042).

For the transition services dimension, the differences were statistically significant between:(1) intellectual disability and hearing disability, in favor of intellectual disability (MD = 5.662; p = 0.004); (2) intellectual disability and autism, in favor of intellectual disability (MD = 4.881; p = 0.000); (3) intellectual disability and learning disabilities in favor of intellectual disability (MD = 2.515; p = 0.017); (4) multiple disabilities and autism, in favor of multiple disabilities (MD = 5.314; p = 0.002); (5) multiple disabilities and learning disabilities, in favor of multiple disabilities (MD = 2.948; p = 0.046); (6) multiple disabilities and hearing disability, in favor of multiple disabilities (MD = 4.304; p = 0.033); and (7) multiple disabilities and autism, in favor of multiple disabilities (MD = 3.522; p = 0.012).

In the permissions dimension, the differences were statistically significant between: (1) intellectual disability and hearing disability, in favor of intellectual disability (MD = 3.390; p = 0.031); (2) intellectual disability and autism, in favor of intellectual disability (MD = 2.751; p = 0.010); (3) intellectual disability and learning disabilities, in favor of intellectual disability (MD = 2.979; p = 0.000); (4) multiple disabilities and autism, in favor of multiple disabilities (MD = 2.703; p = 0.045); and (5) multiple disabilities and learning disabilities, in favor of multiple disabilities (MD = 2.931; p = 0.013).

For the questionnaire total score, differences were statistically significant between:(1) intellectual disability and hearing disability in favor of intellectual disability (MD = 35.987; p = 0.006); (2) intellectual disability and autism, in favor of intellectual disability (MD = 28, 500; p = 0.002); (3) intellectual disability and learning disabilities, in favor of intellectual disability (MD = 26.308; p = 0.000); (4) intellectual disability and multiple disabilities, in favor of intellectual disability (MD = 12.916; p = 0.027); (5) multiple disabilities and hearing disability, in favor of multiple disabilities (MD = 32.429; p = 0.029); (6) multiple disabilities and autism, in favor of multiple disabilities (MD = 24.941; p = 0.027); and (7) multiple disabilities and learning disabilities, in favor of multiple disabilities (MD = 22.750; p = 0.021).

Differences in the IFSP practices based geographical regions

To explore differences in the current practices of the IFSP by geographical region, the ANOVA test was conducted. The results are presented in Table 7.

Table 7.

ANOVA for differences in the current practice of the IFSP based on geographical regions.

Dimensions		Sum of Squares	Df	Mean Square	F	Sig.
Initial data	Between groups	1394.969	4	348.742	5.629	.000
	Within groups	12824.786	207	61.955
	Total	14219.755	211
Information about the child and the family	Between groups	1124.508	4	281.127	6.187	.000
	Within groups	9405.624	207	45.438
	Total	10530.132	211
Present level of child’s development	Between groups	792.824	4	198.206	5.984	.000
	Within groups	6856.195	207	33.122
	Total	7649.019	211
Early intervention services	Between groups	1618.080	4	404.520	5.387	.000
	Within groups	15542.878	207	75.086
	Total	17160.958	211
Transition services	Between groups	358.490	4	89.623	3.478	.009
	Within groups	5334.015	207	25.768
	Total	5692.505	211
Permissions	Between groups	295.815	4	73.954	4.747	.001
	Within groups	3224.954	207	15.579
	Total	3520.769	211
Total	Between groups	29975.339	4	7493.835	6.987	.000
	Within groups	222015.657	207	1072.539
	Total	251990.995	211

As shown in Table 7, there were differences among all the dimensions and the total score. To identify the direction of these differences, the Scheffe test was used for post-analysis. In the initial data dimension, differences were statistically significant between (1) the central region and southern region, in favor of the central region (MD = 5.751; p = 0.002), and (2) the northern region and southern region, in favor of the northern region (MD = 6.984; p = 0.014). For the information about the child and the family dimension, differences were statistically significant between (1) the central region and southern region, in favor of the central region (MD = 5.068; p = 0.001) and (2) the northern region and southern region, in favor of the northern region (MD = 6.855; p = 0.003).

In the present level of the child’s development dimension, differences were statistically significant between (1) the central region and southern region, in favor of the central region (MD = 4.526; p = 0.001) and (2) the northern region and southern region, in favor of the northern region (MD = 5.106; p = 0.014). For the early intervention services dimension, differences were statistically significant between the central region and the southern region in, favor of the central region (MD = 6.800; p = 0.001). In the transition services dimension, differences were statistically significant between (1) the central region and the southern region, in favor of the central region (MD = 2.988; p = 0.024). For the permissions dimension, differences were statistically significant between (1) the central region and the southern region, in favor of the central region (MD = 2.862; p = 0.002).

In the total scores, differences were statistically significant between (1) the central region and southern region, in favor of the central region (MD = 27.995; p = 0.000) and (2) the northern region and southern region, in favor of the northern region (MD = 30.428; p = 0.008).

Discussion

The study examined the current practices of the IFSPs for young children with disabilities in Saudi Arabia and the significant differences among the independent variables (early intervention providers’ major, type of institution, number of courses in the IFSP, type of disability/disorder and geographic region) and the dependent variable (questionnaire items). The findings of the present study revealed that the current practices of the IFSP are often provided to young children with disabilities in Saudi Arabia. This applied to all the dimensions of the questionnaire, whose order from the highest to the lowest was: initial data, the present level of the child’s development, permissions, early intervention services, information about the child and the family and transition services. This finding is partly consistent with the study conducted by Younis et al. (2014) to explore the extent to which special education teachers in Saudi Arabia are cognizant of the Council for Exceptional Children (CEC) criteria for early intervention. Teachers’ knowledge in that study ranged from average to above average.

Nevertheless, the findings of the present study are inconsistent with the results of previous international and local studies that evaluated early intervention services (Al-Ghamdi 2009, Al-Qahtani 2016, Al-Qarani and Bataynah 2007, Kamal 2014, Merzza 2005). Findings of those studies showed a general weakness in early intervention services. The discrepancies between the results of the present study and those of these previous studies can be explained in terms of recent developments that might have affected the practices of the IFSP in the country. All four studies were conducted before 2016, and developments that Saudi Arabia witnessed in the services provided to individuals with disabilities after 2016 might have affected all aspects of early intervention. The quantitative development of early intervention services reported in several studies is surely associated with qualitative development. We observed that the questionnaire dimensions of information about the child and the family and transition services were ordered last, which can be explained by the fact that these dimensions entail cooperation and familiarity with the information required from the families. Several studies of families of children with disabilities have reported poor cooperation between families and service providers. Transition services are among the most recent services to be introduced in the field of special education in Saudi Arabia. This can explain why transition services have not yet been properly included in early intervention programs. This finding is also similar to studies conducted in other Gulf countries, for example, the United Arab Emirates and the Sultanate of Oman (Al-Fawaeir 2015, Al-Naimi 2008), where early intervention programs were reported to increase in effectiveness. Further, we found consistency with the results of a previous study by Ziviani et al. (2013) that showed positive attitudes toward early intervention service quality and providing different kinds of support to children and families.

The results of the study also revealed that service providers’ academic majors partially impacted the rating of the level of application in the initial data dimension. The ratings of social service specialists were significantly higher than other specialties. The academic major also affected (1) the early intervention services dimension, where differences were in favor of applied medical science specialists and special education specialists, and (2) the early intervention services dimension, where differences were in favor of social service specialists. These findings can be interpreted in light of the service providers’ major. Social service specialists are known to be more concerned with initial data, whereas applied medical science specialists are more focused on early intervention services.

The type of institution providing the service proved to affect the practices of the IFSP for young children with disabilities in Saudi Arabia. It affected all the questionnaire dimensions and the total score. Differences were statistically significant between (1) special education centers and special education schools in favor of special education centers and (2) other institutions and special education schools in favor of other institutions. Almost all the differences in the other dimensions were in favor of other institutions. This result is similar to that reported in the study by McWilliam et al. (1998), wherein differences were found in applying the IFSP based on the type of institution providing early intervention services. These results may be due to the other institutions not mainly specializing in early intervention services; thus, their ratings were different from the institutions that provided early intervention services and programs independently and separately from any other services for persons with disabilities.

No significant differences in the ratings of the IFSP practices by number of training courses were reported in the present study in the total questionnaire score and most of its dimensions. Nevertheless, only transition services showed significant differences in favor of specialists who received more training courses in early intervention. This result can be linked to the first question regarding where transition services came last among all questionnaire dimensions. This could be due to the novelty of this aspect of early intervention services. It can be assumed that the novelty of this aspect has made training courses of noticeable impact on developing specialists’ awareness of the practices of transition services and their inclusion in the IFSP practices. Several differences in IFSP practices in Saudi Arabia by type of disability/disorder were found in the present study. This applied to the total score and all dimensions of the questionnaire. This result reveals a clear discrepancy in implementing the IFSP for various disability categories that institutions deal with.

Lastly, the results revealed variations in IFSP practices in Saudi Arabia by the geographical region in which the early intervention service is provided. This applied to the total score and each questionnaire dimension. Differences between the central region and the southern region were statistically significant in favor of the central region in the total score, initial data, information about the child and the family, the present level of the child’s development, early intervention services, transition services, and permissions. Statistically significant differences were found between the northern and southern regions in favor of the northern region in the total score. This finding concurs with a study by Ridgley and Hallam (2006) that found variations in the application of the IFSP for young children with disabilities in rural communities. This result can be explained in light of the fact that the central region includes the capital city of Riyadh and other major nearby towns. It is known that capital provides better services for persons with disabilities. Differences between northern and southern regions in favor of the northern region can be attributed to better knowledge and awareness of disabilities in northern region (General Authority for Statistics 2017).

Conclusion

The present study examined the current practices of the IFSP for young children with disabilities in Saudi Arabia. A sample of 212 male and female early intervention providers were surveyed. The IFSP questionnaire was based on Maryland State’s IFSP form. The findings of the study revealed that the current practices of the IFSP are often provided to young children with disabilities in Saudi Arabia.

The study was conducted on a sample representing a wide variety of specialists working in centers and institutions that provide early intervention services and programs in all the regions of the Kingdom of Saudi Arabia. This sample is the largest compared with other studies conducted in Saudi Arabia. It is the largest in terms of representation of the various regions of the Kingdom, which, according to the researchers, makes it possible to generalize its results to early intervention services in all regions of the country.

Nevertheless, there are some limitations to the present study. One limitation is that the study is based on the Maryland model of the IFSP for young children with disabilities. The study’s tool was developed entirely based on this model. Furthermore, it would be better to obtain and analyze copies of children’s IFSPs, which is difficult because children’s data is strictly confidential. We also recommend that future research focus on IFSPs for young children with disabilities in light of multiple international models. An additional area that needs to be explored in this field is the satisfaction of the families and specialists who implement these plans.

The results of this study have many implications. First, the IFSP in Saudi Arabia needs to be updated in terms of information about the child and family and transition services. Second, service providers of various specializations need to be trained on all aspects of the IFSP. Third, provision of early intervention services should be limited to specialized institutions. Finally, early intervention centers and institutions in the southern region need to receive ample attention so they can match the level of the intervention centers in other regions of Saudi Arabia.

Funding Statement

This work was supported by the Deanship of Scientific Research at King Saud University under grant number RGP-1440-008.

Conflict of interest

No potential conflict of interest was reported by the authors.