OT Corner: What To Expect From Your Early Intervention OT
By Amy Wagenfeld, Ph.D., OTR/L
Originally printed in March, 2005

This month, I would like to focus on a specific area of service 
that might have you meeting an occupational therapist for the 
first time.  Early Intervention (EI) is a federal entitlement (we’ll 
talk about this in a few moments) under the Individuals with Disabilities 
Education Act (IDEA), providing for up to 16 different types of services 
for the 0 to 3-year old populations.  Early intervention is family-
centered in that services are provided to not only the child, but to 
the whole family, with the understanding that a child generally tends 
to develop “best” when in a supportive, safe, and nurturing home 
environment.  One of the many stand out features of EI is the fact 
that therapy services are not necessarily carried out as clearly 
defined roles.  Instead, roles blur; everyone is considered an equal 
player, and that, of course, includes the parents.

Early intervention is a federal entitlement that is directed by each state.  
It is part of the IDEA (Part C) and serves the 0-3 age groups only.  
Preschool age services fall under Part B of IDEA, which we will talk 
about next month.  What is particularly unique about EI is the fact that 
it is directed towards coordinated care for infants, toddlers, and 
their families.  One thing that you may experience is a single practitioner 
providing the bulk of your therapy services.  This practice of the blurring 
of professional roles is done to offer the most integrated and collaborative 
services possible.  It has been my experience that if your child receives 
EI services, that the service coordinator is generally one whose professional 
training most closely matches your child’s needs.  For example, if your 
child seems to show only language delays, your services will be coordinated 
by a speech therapist, and if the issues have to do with fine motor delays, 
an occupational therapist will likely be the services coordinator and 
facilitator.  That isn’t to say that the OT will not address language issues, 
because, as I mentioned, the roles do blur in EI services.

Eligibility for EI services is based on three factors, one of which includes 
an established risk. Being a HOM is an example of an established risk. 
In other words, a child with a set diagnosis that requires services will 
likely be eligible to do so.  The other two criteria for determining whether 
an infant is eligible for EI is a developmental delay (which is determined 
through an evaluation process) and finally, a child who is at risk may be 
referred to EI, and then subsequently receive services.

The legal document that is developed to identify the outcomes for both your 
and your child(ren) is called an Individualized Family Service Plan (IFSP).  
This serves as a map of the family’s services to be received, by whom, 
where, and when.  The IFSP is reviewed every six months, and you, as the 
parents, are critical in helping to develop this plan.  The role of an OT 
is a vital part of EI services.  In general, your OT will look at and help 
to directly or indirectly (as part of the team) develop a plan of action 
for working on fine motor development and hand function, development of 
play skills, sensory integration, oral motor function and feeding, and 
adapted equipment and positioning.

Early intervention services are very important to not only your babies, 
but to you as well, as the early years are a very important time for 
development.  Let me leave you with these thoughts: Receiving early 
intervention services is not necessarily a future predictor for what WILL 
BE in terms of your childrens' futures.  What I am trying to say is, no 
matter whether your child is eligible for EI services based on simply an 
established risk, a developmental delay, or is identified as being at risk, 
it does not mean the future is bleak.  In fact, study after study shows 
that children, whether they are termed as an established risk, have a 
developmental delay, or are clearly identified as being at risk, who 
receive services early on have a greater advantage over one who does not 
receive them.  Likewise, and as I mentioned, EI services are FAMILY 
oriented, so not only do your children benefit from services, so can you.  
I have always worked with my families on not only "child" issues, but 
also issues about parenting and things that simply come up in the course 
of being a caregiver.  Can you tell I am a firm believer in early intervention 
services?

Next month we will talk about IEP’s, and begin to talk about preschool 
services, and if space allows, start to explore school-aged services.