Early Intervention

Early Intervention (EI): federally mandated program of coordinated services & support through IDEA Part C that helps minimize the impact of developmental delays or disabilities on a child's development

• improved outcomes - can change a child's developmental path, leading to improved outcomes for child & family

• reduce long-term effects - alleviate financial burdens in the long run by reducing the need for continuing intensive therapy

• earlier is better - connections in a child's brain are most adaptable in the first 5 yrs of life, forming the foundation for learning, behavior, & health, so intervention is likely to be more effective when provided earlier than later in life

Developmental Disability: deficits that children typically do not outgrow or catch up from - most children will make continual progress at a slow, but steady rate Developmental Delay: may be caused by temporary issues or be secondary to learning & attention challenges

• Delay in one or more areas of development

• often considered a substantial lag versus just being behind

• Vary based on the child's chronological age and other factors like prematurity, twin birth, & environmentc

Referrals

• Once a referral is made, the process must be completed within 45 days

• Sources include

  • parents & family members

  • pediatricians

  • medical specialists

  • VNA (community nursing)

  • DCF (dept of child & family)

  • hospitals

  • other states

Process

• Referral/Intake - gathering of a child & family information with parent/caregiver

• Evaluation - completed w/ child & family - using a multidisciplinary team where eligibility will be determined that day unless clinical judgment is enacted

• IFSP - developed between primary service provider - how often/duration decided by both

• Re-evaluation - determine eligibility happens yearly (6 mons if clinical judgment)

Eligibility Criteria - 4 Points of Access

• Developmental Delay - determined by Batelle (BDI-3)

  • delay in 1 or more areas

  • delay is 30%

  • developmental quotient of <77

  • eligibility is for 1 yr

• Diagnoses - established diagnosis list by state

  • Most diagnoses make child eligible for up to 3 yrs of services

  • Other diagnoses allow for 1 yr of eligibility 

• Risk Factors - established risk criteria enabling 1 yr of eligibility

  • Medical Risk - prematurity, birth weight, lead levels, etc.

  • Family Risk - maternal age, maternal education, domestic violence, DCF, etc

  • Must have 5 risk factors total from either area for eligibility 

• Clinical Judgement

  • used by a clinician completing the evaluation in the area of concern

  • child does not meet any of the above listed eligibility criteria

  • eligibility for 6 mons of services

Services

• Service delivery may include:

• • home visits

  • groups

  • co-treatments

  • evaluations (& re-evaluations)

• Included Team Members

  • SLPs

  • PTs

  • Teachers

  • Behavioral specialists (e.g. BCBA)

  • Social workers

  • Service coordinators (state-based)

Transitions

• Discussed at every ISFP review

  • EI to PreK (school systems)

  • EI to another EI (in or out of state)

  • EI to community services (if no longer eligible prior to 3 yrs or family declines services or referral)

• Can be stressful time for families

• School transitions begin at 30 mons

Payment

• Varies from state to state

• Private insurance

• Medicaid

• Other payment considerations

• Should be family-focused

  • What is the perception of the child's needs?

  • What are concerns for the family (e.g. housing, daycare, etc).

  • Inclusive of daily routines & customs/beliefs

  • Natural environments

• Necessary & functional

• Jargon & discipline-free

• Stated in a positive way

• Typically written for 1 yr

• Play!

  • Adapting play (assistive tech)

  • Go-Baby-Go

• Sensory Processing

  • Arousal levels

  • Feeding, ADLs

• Social Participation

  • Siblings, other children, parents

• Sleep