Early Intervention

Question 1

Early intervention services

Answer 1

• services for children from birth to three years old
• children with an established risk, developmental delay, or environmentally or biologically at risk
• enchance the development of infants and toddlers with disabilities, minimize potential for developmental delay, recognize significant brain development occurs during the first three years of life

Question 2

Components of the Individuals with Disabilities Education Act (IDEA)

Answer 2

• federal law
• states must actively identify, locate, and evaluate children ages 0-21 who have disabilities or are suspected of having disabilities
• Part C provides early intervention services for children ages 0 to 2 years and 11 months (each state established its own eligibility definition)
• services are free!

Question 3

Part C (ages 0-3)

Answer 3

• OT as the primary service
• Individualized Family Services Plan (IFSP)
• family centered
• natural environment

Question 4

Part B (ages 3-5)

Answer 4

• OT is not the primary, more so as a related service (has to have another service, generally speech and language or education)
• Individualized Education Plan (IEP)
• home, center, school-based

Question 5

Part A (ages 5-21)

Answer 5

• OT as related service
• Individualized Education Plan (IEP)
• child focused related to curriculum standards

Question 6

Qualification in Missouri (qualification standards differ from state to state)

Answer 6

• from the NICU and meets the requirements: birth weight less than 1500 grams (3.3lbs), intraventricular hemorrhage, ventilator (not all kids in NICU mean they qualify, they have to have the parameters to meet)
• assessed and found to have a 50% delay in one or more of the following areas: cognition, total communication, social emotional, physical development, and adaptive
• has a diagnosis with an automatic qualification (ex: Down Syndrome, CP, Blind, Deaf, Cleft lip)

Question 7

Family centered care

Answer 7

• families are treated with respect and emphasis is placed on families’ strengths
• families participate in goal setting and intervention planning for their child
• families have the choice of the types of services their child receives and where
• families and service providers work as partners to collaborate in decision making and care implementation
• family capacity to support the growth and development of their child with special needs is emphasized

Question 8

Transdisciplinary Model in many states

Answer 8

• one service provider is the primary and others serve as consultants
• service provided is dictated by parents’ primary concerns
• primary interventionist supports and provides functions typically performed by another profession
• OT generally comes in on feeding, sensory, and limb deficiencies concerns

Question 9

Family centered practice

Answer 9

• assessment
• intervention
• transitional planning

Question 10

Assessment

Answer 10

• integrated developmental model observe child’s skills across a range of contexts vs a test score
• assessment involves multiple sources and components of information
• strong understanding of child’s development
• focus on functional capacities such as attending, engaging, reciprocating, interacting, intentionally, organized patterns of behavior, and problem-solving
• identify current abilities, strengths, and areas of need
• all assessment completed with parent
• standardized testing provides information, but does not determine services

Question 11

Outline of assessment

Answer 11

• occupational profile
• observation of family and child engaging in routines and occupations within the natural environment
• standardized assessment (often DAY-C)
• informed clinical opinion = practitioners’ clinical thoughts based upon qualitative and quantitative information regarding difficult to measure aspects of need for intervention (need to advocate for the family)

Question 12

DAYC-2 (Developmental Assessment of Young Children-Second Edition)

Answer 12

• norm referenced measure of early childhood development
• administer in natural setting though observation and parent/caregiver interview
• birth through age 5 years and 11 months

Domains:
- cognition
- communication
- social-emotional development
- physical development
- adaptive behavior

Question 13

Plan: Individualized Family Service Plan (IFSP)

Answer 13

• child’s present level of motor, cognition, communication, social-emotional, and adaptive development
• family priorities and concerns
• major outcomes to be achieved and timelines (IFSPs are generally done every 6 months)
• specific early intervention services necessary with frequency
• natural environment in which services are provided
• service coordinator identified
• transition plan

Question 14

Plan: Outcomes

Answer 14

• reflect family priorities, hopes, and concerns
• dictated by family goals for child’s participation in family routine and life
• real life contextualized settings (not assessment items)
• outcome is discipline free (not tied to OT, PT, SLP)
• strengths-based approach: the outcome emphasizes the positive, not the negative
• the outcome is jargon-free, clear, and simple
• the outcome uses active words vs passive ones
• outcomes may include participation in community activities that are meaningful for the family

Question 15

Functional outcome goal examples

Answer 15

• Grant will enjoy face-to-face games and songs with mom when they are playing together.
• Jordan will play independently for up to three minutes while mom is in the bathroom.
• Isa will enjoy going to the grocery store with mom.

Question 16

Intervention

Answer 16

• within the natural environment = where does the child spend their days?
• home
• grandparents’ home
• daycare
• play
• social interactions and participation
• eating
• sleeping
• beginning toileting
• regulation
• family-centered

Question 17

Embedded coaching

Answer 17

• initiation = family identifiers a need and a joint plan is developed
• observation = therapist observes parent, therapist models behavior, parent thinks about child’s skills while performing occupation, therapist/parent observer aspects of environment
• action = parent engages in occupation on own
• reflection = therapist questions how it went
• evaluation = therapist evaluates effectiveness of coaching

Question 18

Discharge/transitional planning

Answer 18

• when a child turns two (24 months), plans begins for the child to transition from early intervention to preschool
• often stressful because of the change of environment, change of providers, and change of delivery model

Question 19

Occupational justice issues

Answer 19

• lack of providers