I am a pediatric occupational therapist, but the bulk of my experience has been in Pennsylvania's Early Intervention program. Do you know what early intervention (EI) is? I hope so, but I know that many of you don't. I want to rectify that because if you are living in the United States and have a child under the age of 5 you may qualify for these free services. Each state's rules and guidelines are a little different, my state is known for their excellent services, but others aren't so much. One thing each state does have in common is that if your child is 0-3 and has a delay in any area of development, a qualified and licensed speech, physical, or occupational therapist will come to your home to work with you and your child. In our state we also have developmental therapists, which usually have backgrounds in education or development, as well as vision/hearing therapists and social workers. That is pretty awesome, right? Your child has a need, which may be minor, and the state sends someone to your home to help. You don't even have to drive anywhere! If your child is 3-5, it may not be too late for EI, but the model is a little different. I'll elaborate more on that briefly.
Okay, so let me back up a little here. Before you get services set up in your home, you will have a developmental screening completed. A therapist(s) will come to your home and basically "play" with your kiddo. This play will be targeted to specific skills as they evaluate if your child is meeting typical milestones for their age. This evaluation or screening is formal though, therapists are following specific tested guidelines. Of course, there is a lot of leeway here, therapists know better than anyone that development varies from child to child. The therapist evaluating will likely ask you a lot of questions as well, to fully understand your concerns and the needs of your child. They will score the evaluation and let you know the results and their recommendations If therapy is recommended, it will be up to you as the parent to continue with services, there is no pressure. Sometimes the screening is completed and your child doesn't qualify. That is a very quick overview of EI! Now, onto some FAQ's!
What kinds of things can EI help with?
Generally speaking EI will address any area of development that your child is delayed in, which is determined by the state and screening tool used. In most states, that means (but could include more or less):
- Gross Motor Skills (rolling over, crawling, walking, managing stairs, jumping, climbing)
- Fine Motor Skills (pincer grasp, pointing, puzzles, stacking blocks, coloring, cutting, handwriting, etc.)
- Speech/Communication (following directions, speaking, speaking clearly, participating in conversations, etc.)
- Social Skills (playing with peers, separating from parents appropriately, behaviors such as biting, hitting, headbanging, etc.)
- Daily Living Skills (dressing, using utensils, drinking from a cup, understanding caution in dangerous situations)
- Vision and Hearing
I want to remind parents reading this list, again, that many of the milestones listed can vary. Also, some of the social skills listed may be age appropriate, some kids go through minor phases of biting or hitting. If you aren't sure, talk to your pediatrician or call for a screening in your state. Keep in mind that you can call on your own, it's always a good idea to talk to your doc, but if you have a nagging feeling, I would recommend giving your state a call (I'll give you a resource for that in a minute.)
What about Feeding and Sensory Processing?
I think this comes as a surprise to most people and I wish I could send a letter to every parent across the US and let them know that YES if your child is having difficulty eating your state probably considers this a delay and will provide EI therapy in your home. Most states provide help for feeding and sensory processing difficulties. As an EI therapist, these are the skills I have worked on the most - hence this blog. Below are some of the common types of feeding and sensory processing issues that are addressed, but this list isn't inclusive, so if you aren't sure call and ask!
- Feeding/Eating (picky eating, difficulty transitioning to table foods, food refusal, poor nutrition, low weight, gagging/vomiting during eating, difficulty chewing or swallowing, etc.)
- Sensory Processing (refusing to touch or eat certain textures, crying or discomfort while touching different textures, excessively seeking out movement, dangerous climbing and jumping, poor attention, frequent rocking/swinging/headbanging, difficulty with hair washing or bathing, etc.) *Please note many of these behaviors may be due to other factors, a qualified therapist would be able to determine if there were sensory based.
If you have more questions about sensory processing, click this link or see the tab in the menu at the top. Also, note that even states that offer services up to age 5 usually cut off feeding and sensory at age 3.
What are other options for therapy? What if I need more help?
If your child didn't qualify for services in your state and you want another opinion or still feel like you need help you can consider outpatient services. These services can also be used in addition to EI therapy. Pediatric hospitals and private clinics are just about everywhere now. Medical insurance is accepted at most, but paying out of pocket is possible, but not likely. Make sure you speak with your insurance provider before scheduling an evaluation.
I offer private consultations at a very affordable price via phone, skype, or facetime as well. Many families have used this in conjunction with their EI services or before their services have begun because the process can take a few weeks to a month or two. Also, in some remote locations outpatient services can be difficult to reach. More information is in the top menu under the tab Consulting Services.
Services for kids 3-5 aren't available in every state and in the ones that do it is often preschool based. This really varies a lot from state to state, so it's something you will want to look into. In this case, you may want to consider one of the the other options I described, as school based therapy likely won't be as regular.
Why do states offer this free* help?
States are required to offer free help for children under the age of 3 because of a law that congress established in 1986 called Part C of IDEA (Individuals with Disabilities Education Act). The act requires states to establish what they consider a developmental delay is and if it puts them at risk for disabilities. Some states have managed to find ways to create minimal fees, but most are free and should be. If you are interested in more information on the law click here because I am giving you the watered down version.
How can I find services in my state?
My original plan was to provide a list of each and every state with all of the needed contact info. But, I Can Teach My Child already took care of it, so I thought... why reinvent the wheel? Click here to check out their awesome and thorough list of phone numbers, addresses, and emails by state. NICHCY is also a wonderful resource.
Still have a question about how this all works? Leave a comment- I will answer! If you have experience with a particular state, PLEASE leave a comment. I would love to have more information about the quality and ease of services in each state, as well as, if any services such as feeding weren't provided.