By Gregory Paquette
Director of Business Optimization, M.S., BCBA
Early Intervention is an extensive service delivery model, focusing on a wide array of services that are of the utmost importance for young learners. While Early Intervention has been around for many years across the U.S. and other countries, the service model is gaining new-found traction among practitioners of all disciplines to ensure young learners have access to Early Intervention Services. Due to the delivery model’s recent momentum and need due to rising rates of developmental disabilities, we would like to describe in more detail what Early Intervention is and why these services can be an essential factor for us to examine in more detail.
What is Early Intervention (EI)?
Early Intervention (EI) is a program for infants and toddlers (birth to age three) that have developmental delays or are at risk of a developmental delay. EI services are a targeted range of services that help these children grasp foundational concepts and meet physical, cognitive, communication-based and/or behavioral milestones, and more. Early Intervention services are provided under the Individuals with Disabilities Education Act (IDEA) and are typically provided in-home or in other community settings where the child lives and plays, focusing on early learning skills and education of the family unit. Early intervention services are provided by a team of professionals, with the family as the center of the team, while family routines and priorities guide what and how services are provided. While it is typical for the bulk of the services to be directly provided to the child by the early intervention professional, it is critical to have family involvement to support the child, share knowledge, and help pass teaching methodologies to the family for generalization when EI professionals are not present.
In order to qualify for EI services, a child must be under the age of three (some states up to age five) and be experiencing some type of developmental delay (cognitive, social, emotional, behavioral, communication, etc). EI services are funded by federal, state and local funds, with the services provided through a variety of public and private agencies specializing in the development of infants and toddlers. However, in some states, families may use their personal insurance to receive EI therapy for their young child. While the therapy may be similar and target these similar deficits, these therapy services are different than those of a state-run program under the IDEA act. Similarly, some behavioral-based agencies provide Early Intensive Behavioral Intervention (EIBI) which targets similar early learning and foundational skills, but EIBI is a methodology, not a state-run program.
How it Works
As mentioned above, the IDEA provides resources for children to receive the services they need in their respective states. The government provides grants to each state, to ensure children have access to services either free of charge or at a low cost. Each state has different laws and regulations in regards to the service offerings they can provide, whether or not a diagnosis is required, the frequency/length of services mandated, and so forth.
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Typically, an evaluation is necessary to get started. An evaluation may be recommended by a pediatrician, a daycare staff worker, or another childcare professional, but also by a caregiver that senses some delays and wishes to get a start on potential services. An evaluation will determine if the child is eligible for services. If they are, your state’s approved EI agency will assign the caregiver with a Service Coordinator and a team of professionals that will help create goals for these services. The goals of Early Intervention will depend on the unique area(s) of need for the child, paired with the family’s priorities. Meaning, if your child needs services that target physical delays, an occupational therapist or a physical therapist may work with your child. Further, a developmental specialist or a speech pathologist may work with your child for goals in their respective areas of expertise. The care team will work with the caregiver and other family members to create an Individualized Family Support Plan (IFSP).
The IFSP is where the right amount of appropriate services and goals are outlined. The IFSP team will meet frequently throughout treatment to ensure the child is receiving the correct amount of services and that the child is progressing in their skill areas. In addition, sometimes a child may need behavioral assistance or extra support from a specialty service provider, such as an Applied Behavior Analysis (ABA) provider, who will work with the child to focus on other areas of concern. Typically, the specialty service provider is with an outside agency that works frequency with the EI agency.
Statistics at a Glance
The rate of developmental disabilities is increasing drastically. As such, we must reach as many children as possible, and ensure that infants and toddlers meet their developmental milestones.
Rates of developmental disabilities:
- The prevalence rate of developmental disabilities for children ages 3 to 17 in the United States rose from 5.76% in 2014 to 6.99% in 2016.
- The prevalence of children who’d been diagnosed with a developmental delay other than autism spectrum disorder or intellectual disability also increased from 3.57% to 4.55%.
Prevalence of children diagnosed with any developmental disability (2014 – 2016)
Source: U.S. Centers for Disease Control and Prevention.
Understanding Early Intervention:
- Children who begin therapy at a younger age make greater gains than those who enter programs at older ages (Harris & Handleman, 2000)
- For kids that received early intervention between age 2-5, it is estimated that $187,000-203,000 was saved per child aged 3-22 years old and $656,000-1,082,000 per child from 3-55 (Jacobson et. al., 1998)
- “An increasing body of empirical research suggests that early, intensive, structured intervention, based on the principles of applied behavior analysis, is effective in remediating the intellectual, linguistic, and adaptive deficits associated with autism”. (Remington et. al., 2007)
“Early intervention services help children from birth to 3 years old (36 months) learn important skills. Services can include therapy to help the child talk, walk, and interact with others. Therefore, it is important to talk to your child’s doctor as soon as possible if you think your child has ASD or other developmental problem.” (http://www.cdc.gov/ncbddd/autism/facts.html)
“It’s very promising to see that children who received two years of early intensive intervention required fewer hours of therapy and special education services through the remainder of their preschool years…” (https://www.autismspeaks.org/science/science-news/high-quality-early-intervention-autism-more-pays-itself)
Why is Early Intervention Important?
As noted in the statistics above, children simply learn better and make greater strides when EI services are provided sooner rather than later. Simply put, the more practice children have at foundational skills, the quicker they will learn them. These critical skills are often called “core skills,” “prerequisites” or “pivotal skills.” If children learn these core skills earlier, then they will have more opportunities and more practice to work on the skills that are built upon their early skills. The value of Early Intervention is in comprehensive, government-supported services that help young children get on the right learning trajectory from their first years.
About the Author
Gregory Paquette, M.S., BCBA
CentralReach Director of Business Optimization and Certification
Gregory Paquette has been working in the field of Behavior Analysis since 2005. He received his Master’s degree in Applied Behavior Analysis and became board certified in 2008. Gregory started his work in the field at the renowned New England Center for Children outside Boston, MA, where he served a variety of roles helping children and adults with autism and related disabilities reach their full potential. After leaving the center, Gregory worked as a BCBA conducting school and home consultation in both Massachusetts and Florida. While serving as a Director at Butterfly Effects, he oversaw ABA services in the Southeast United States and later opened an Early Intervention services division for a large agency in western Massachusetts. His passions in the field include building independent living skills for consumers, increasing effective supervision processes and limiting staff errors while increasing quality assurance in program implementation. Since starting at CentralReach almost 5 years ago, Gregory has worked across departments, helping clinical users onboard, implement, and roll out their workflows agency-wide using the platform. His current focus is working to develop a CentralReach Certification program as well as developing a team of experts to assist in optimizing our customer’s day to day workflows.