Early Intervention

What is an Occupational Therapist’s role in Early Intervention?

Early Intervention (EI) embodies the concept that occupational therapy offers a holistic approach, incorporating all aspects of a person, including their family. Within EI, occupational therapists offer services not only to the child, but offer families strategies and tools to utilize within their natural environment (the grocery store, playground, home, etc.) as well. The targeted population for receiving EI services are babies and young children up to 3 years old with developmental delays or disabilities that put them at risk for delays.

EI families are not only limited to receiving services from occupational therapists, but rather, they may have a speech language pathologist, physical therapist, or other types of services on their team as well. These types of programs are available in every state and are provided for free or at a reduced cost to an eligible child.

A program list can be found here: https://www.cdc.gov/ncbddd/actearly/parents/states.html#textlinks

The American Occupational Therapy Association determined that there are 8 core principles of occupational therapy services provided within EI:

1. Occupation: support the occupations of infants and toddlers through strategies in play, sleep, feeding, dressing, toileting, social participation, and education.
2. Participation: occupational therapy services support both a child and family’s meaningful participation in occupations.
   1. A key principle of EI states that “infants and toddlers learn best through everyday experiences and interactions with unfamiliar people in familiar contexts.”
3. Natural Environment: because this is a service provided under IDEA Part C, EI must be provided in settings that are typical for the child and children his/her age. Services most often are provided within a family or community setting.
4. Family Routines and Rituals: occupational therapists prioritize the routines of families and will then create an individualized plan that meets the family’s needs and priorities of the child, while respecting a family’s learning styles, rituals, and daily routines.
5. Culturally Sensitive: occupational therapists prioritize and support the cultural beliefs and engagement of both children and families. While offering strategies to encourage participation and occupation, occupational therapists understand the influence that culture may have on activities and routines.
6. Evidence-Based: occupational therapy is a science-driven profession, in which practioner’s must always apply the most up-to-date research to service delivery.
7. Addressing a Family’s Capacity: an occupational therapist needs to understand a family’s access to resources in order to best support their needs. An occupational therapist must meet a family “where they are at” and provide the resources that will support them in whatever goals/concerns they prioritize. To best support this principle, an occupational therapist will utilize what is within the natural environment when delivering services, rather than exposing a child or family to outside materials. Using what is in the natural environment will help educate families on effective strategies to use on their own, while meeting them where they are in terms of resources.
8. Family-Centered: occupational therapists understand and prioritize the concept that family members and caregivers know their child the best. Collaboration between professionals and family members is a necessary step in effective EI services. Services provided are based on the priorities noted by family members, and not just the developmental delays of the child.

What would an initial visit look like?

After an Individualized Family Service Plan (IFSP) is formulated to meet the listed goals and objectives stated by the caregivers. It is up to members of the planning team on whether or not a child needs occupational therapy services. The key aspect of the initial visit is to get to know the family of the child, to best create individualized strategies to support a child within their natural environments.

During an initial visit, they will typically meet at their home to get to know the child. Additionally, a therapist will gather information about family routines, beliefs, and any other aspect that a caregiver deems as necessary to share.

An assessment will likely be completed during this initial visit to better understand where the child is developmental in comparison to other children his/her age. This will assess a child’s ability to perform the following skills at an age-appropriate level:

• Motor control
• Hand skills
• Sensory processing/integration
• Visual perceptual
• Social participation
• Play

Going forward, what should a family expect?

A family should expect visits from an occupational therapist within an environment the caregiver feels that their child needs to be supported. It should also be expected that an occupational therapist utilizes play in order to best meet family goals. Play therapy is open-ended, self-directed, and is unlimited in the goals it can address. Objects and materials found within the natural environment should be the focus of play, allowing families to carry over strategies with less disruption to normal routines because materials are readily available within the environment.