Friday, May 10, 2019

American Academy of Pediatrics Report on Prescribing Physical, Occupational, and Speech Therapy Services for Children with Disabilities


Houtrow, A., Murphy, N. & Council on Children with Disabilities. (2019). Prescribing physical, occupational, and speech therapy services for children with disabilities. PEDIATRICS, 143(4), 1-14.  https://pediatrics.aappublications.org/content/pediatrics/143/4/e20190285.full.pdf

The American Academy of Pediatrics recently published a clinical report that provides their members with guidelines for prescribing physical, occupational, and speech therapy services for children with disabilities. The report is available for free download at the URL listed above.

Although this report does not exclusively focus on therapy services for children from birth to three or birth to five, the authors recognize the importance of natural learning opportunities within the context of everyday activities and the important people in the child’s life. Not surprising, the authors still provide that outpatient/clinic-based services may be necessary for children with more complex needs and their examples use a very traditional multidisciplinary approach.

The authors acknowledge the lack of available research for prescribing frequency and intensity of therapy services for a specific diagnosis and only cite one study for one diagnosis (i.e., unilateral hemiplegic cerebral palsy). The report states that dosage is largely “subjective” however, the authors provide guidance for how physicians can prescribe frequency and intensity of therapies. Since physician must determine medical necessity for therapy services to be reimbursed by insurance and Medicaid, coordination among early intervention programs, physicians, and families is essential and this is reinforced in the report.

How can the field of early intervention use the information in this report to coordinate with physicians?

How does your program work with local physicians related to prescriptions for therapy services?

What strategies have you found most successful in fostering physicians’ understanding about how early intervention works with families to determine frequency and intensity of services?

In addition to more research, what does the field of early intervention need to assist with service frequency/intensity decision?



Sunday, May 5, 2019

Coaching Video Resources


Thanks to all who posted on the EI CoP list serv recently about videos they have found helpful for supporting EI practitioners' use of a coaching interaction style to help families build their capacity to support child learning within the context of everyday activities and routines.

Listed below are some of the individual videos, websites containing videos, and materials with videos embedded that were shared by CoP members. We know this is not a complete list of all that might be available. You may add additional resources as comments to this blog post.

Connecticut Foundations of Coaching in Early Childhood: Partnering with Parent and Professionals

Maryland Making Access Happen Coaching Support 

Virginia Ongoing Support for Coaching & Natural Learning Environment Practices: Guidance for Facilitating Reflection with Individuals and Groups   

University of New Mexico Center for Development and Disability: FIT Video Library

Sunday, February 10, 2019

American Academy of Pediatrics Report on Early Intervention


In October 2013, the American Academy of Pediatrics (AAP) Council on Children with Disabilities developed a clinical report published in PEDIATRICS, entitled “Early Intervention, IDEA Part C Services, and the Medical Home: Collaboration for Best Practices and Best Outcomes.” This report was reaffirmed by the AAP in May, 2017. In this report, the Council provides an overview of IDEA, Part C and compares it to the concept of a medical home in pediatrics. The Council also defines “best practice” early intervention models as being family-centered, using a coaching interaction style to build the capacity of caregivers, and promoting child learning within the context of natural learning environments rather than trying to create learning opportunities in artificial intervention settings. The report goes on to inform pediatricians that serving children in both traditional settings in which providers work directly with the child and early intervention programs that focus on building the capacity of caregivers to promote child learning in natural routines and activities can be confusing to families and cause mistrust of the practitioners unless well-coordinated and the differences understood by families.

The AAP report is consistent with DEC Recommended Practices including, but not limited to:

Environment 1
Practitioners provide services and supports in natural and inclusive environments during daily routines and activities to promote the child’s access to and participation in learning experiences.

Family 5
Practitioners support family functioning, promote family confidence and competence, and strengthen family-child relationships by acting in ways that recognize and build on family strengths and capacities.

Family 6
Practitioners engage the family in opportunities that support and strengthen parenting knowledge and skills and parenting competence and confidence in ways that are flexible, individualized, and tailored to the family’s preferences.

Instruction 4
Practitioners plan for and provide the level of support, accommodations, and adaptations needed for the child to access, participate, and learn within and across activities and routines.

Instruction 5
Practitioners embed instruction within and across routines, activities, and environments to provide contextually relevant learning opportunities.

When first published, we at the Family, Infant and Preschool Program (FIPP) sent a copy of the report to pediatricians and family physicians in our catchment area. We also included a letter informing the physicians that FIPP services are provided in a manner consistent with the AAP Council on Children with Disabilities report. We continue to share this report with physicians and families to help ensure their expectations of early intervention services are consistent with the AAP and DEC Recommended Practices.

How are you and your program ensuring that pediatricians and families are aware of this AAP report?

Other report and position statements are available from the AAP Council on Children with Disabilities on topics including fetal alcohol syndrome, nonoral feedings, autism spectrum disorders, motor delays, sensory integration therapies, and assistive technology.

If you are interested in writing a blog about a particular resource or topic, contact Dathan Rush (drush@sheldenandrush.org) or M’Lisa Shelden (mshelden@sheldenandrush.org).


Wednesday, January 23, 2019

Young Children in the Digital Age

What is your point of view on technology and young children?

How do we moderate their use and exposure to screen time when children are born into a world of technology, and when they see the adults around them routinely using technology?

What kinds of conversations have you had with parents about screen time?

Here's a resource from Defending the Early Years: Young Children in The Digital Age: A Parent's Guide

Thursday, January 10, 2019

Welcoming the new year... and our new co-leaders!

Happy New Year! We thank you again for the opportunity to serve as co-leaders of the DEC Early Intervention Community of Practice for the past two years.

We have an exciting update to share with you. Please join us in warmly welcoming our new co-leaders, Drs. M'Lisa Shelden and Dathan Rush!

As we suspect many of you already know, M'Lisa and Dathan have a wealth of hands-on experience, knowledge, and expertise to support and empower others to use recommended practices for young children, providers, and families in EI/ECSE. We look forward to their leadership!


P.S. You may have noticed the change in the blog title, to reflect the new name and structure based on recent changes from the DEC Executive Office. The Special Interest Groups are now called Communities of Practice (CoP). Read more here.  The link to our webpage remains the same.

Monday, July 16, 2018

Child Trends Video: Babies May Understand Words Before They Can Talk

I hardly talk on a more personal level here, but it has been a truly fascinating experience witnessing my infant daughter (now almost 7 months) change and grow particularly in terms of language development. We have been talking a great deal to her (giving a "play-by-play" of what is happening), reading to her (Eric Carle's Brown Bear, Brown Bear, What Do You Hear? and Margaret Wise Brown's Goodnight Moon have been longtime favorites), singing to her, etc... and while I know she is absorbing everything before she can actually express what she knows, I'm always curious about what she understands.

A newly released video from Child Trends explains how babies may understand words before they can talk. The video is available in English and Spanish. 

How do we support parents in exposing their child to language within their existing routines and activities? 

Friday, June 29, 2018

Friday Feature: Building Family Capacity

#FridayFeature:

The Early Childhood Technical Assistance Center's Family Capacity-Building Online Module

What does it mean to build family capacity, and how do we do it? 

What do you currently do to support parents and caregivers in implementing intervention between our visits, within their naturally occurring routines and activities?

See this online module to learn more!

Here's the description from the ECTA Center:

This online module:
  • introduces family capacity-building to practitioners and service providers,
  • explains the steps of introducing new practices to parents and families,
  • includes short video excerpts demonstrating family capacity-building,
  • checks a learner's knowledge understanding through a variety of interactive formats, and;
  • includes a family capacity-building checklist for self-assessment or planning home visits.

American Academy of Pediatrics Report on Prescribing Physical, Occupational, and Speech Therapy Services for Children with Disabilities

Houtrow, A., Murphy, N. & Council on Children with Disabilities. (2019). Prescribing physical, occupational, and spee...