Early Intervention Services

Parents are children’s first teachers.  Through play, communication, and touch, parents convey love to their child as well as information about the world.  During everyday interaction parents teach their children names of objects, how things work, what is safe, and myriad other lessons.  These early experiences prepare a child for social-emotional development, literacy and higher level thinking.

When a child has a hearing loss, parents may be unsure of what to do.  Most parents want help.  The early intervention system – for families with children birth to three with disabilities, including hearing loss – is designed to do just that.

Every state has an early intervention system.  Early intervention services are provided free or at low cost.  Services must be individualized based on the needs of the child and family.  Services must be designed to support each child’s development in the physical, cognitive, communication, social or emotional, and adaptive areas.  To find the early intervention program in your state, go to http://nichcy.org/states.htm [1].  Click on your state, and scroll to Programs for Infants and Toddlers with Disabilities.

Early intervention services are based on a document called an Individualized Family Service Plan (IFSP).  The IFSP can be thought of as an instruction manual consisting of goals for your child and family along with a description of the services and service providers necessary to help achieve those goals.  Parents play an active role in the development of the IFSP.  Although at first you may not feel prepared to take on this role – after all, you probably were not expecting your child to have a hearing loss in the first place – your input will help shape your child’s and family’s goals and services.  Children with hearing loss are at risk of developing language delays, therefore you will want to be sure that your child’s IFSP supports his/her language development in whatever mode (signed, spoken, or both) your family chooses.  If your child has additional disabilities, the IFSP should address those as well.

In order to develop the IFSP there first must be:

• a multidisciplinary (from a variety of professions) assessment of the unique strengths and needs of the infant or toddler;
• identification of all services appropriate to meet the child’s needs;
• a family-directed assessment of the resources, priorities, and concerns of the family; and
• identification of the supports and services necessary to enhance the family's capacity to meet the developmental needs of the infant or toddler.

The IFSP must be developed by a multidisciplinary team, including you, the parents.  The IFSP must be in writing.  It must be evaluated once a year, and the family must be provided a review of the plan at six month intervals (or more often where appropriate).  The IFSP must be developed within a reasonable time after the multidisciplinary assessment is completed.

The IFSP must contain:

• a statement of the infant's or toddler's present levels of physical development, cognitive development, communication development, social or emotional development, and adaptive development.  This statement must be based on objective criteria;
• a statement of the family's resources, priorities, and concerns relating to enhancing the development of their infant or toddler;
• a statement of the measurable results or outcomes expected to be achieved for the infant or toddler and the family.  These must include pre-literacy and language skills, as developmentally appropriate for the child.  This statement must include the criteria, procedures, and timelines used to determine the degree to which progress toward achieving the results or outcomes is being made.  It must also address whether modifications or revisions of the results or outcomes or services are necessary;
• a statement of specific early intervention services based on peer-reviewed (peer-reviewed means that professionals in the field approve of it) research, to the extent practicable, necessary to meet the unique needs of the infant or toddler and the family.  This must include the frequency, intensity, and method of delivering services;
• a statement of the natural environments (such as home or day care center) in which early intervention services will appropriately be provided, including a justification of the extent, if any, to which the services will not be provided in a natural environment;
• the planned dates for initiation of services and the anticipated length, duration, and frequency of the services;
• the identification of the service coordinator who will be responsible for the implementation of the plan and coordination with other agencies and persons, including transition services; and
• the steps to be taken to support the transition of the toddler with a disability to preschool or other appropriate services.

A representative of the early intervention system must explain the contents of the IFSP to the parents.  Informed written consent from the parents must be obtained prior to providing early intervention services.  If the parents do not provide consent with respect to a particular early intervention service, then only the early intervention services to which consent is obtained shall be provided.

Early intervention services include, but are not limited to:

• family training, counseling, and home visits;
• special instruction;
• speech-language pathology services;
• audiology services;
• sign language services;
• cued language services;
• occupational therapy;
• physical therapy;
• psychological services;
• service coordination services;
• medical services only for diagnostic or evaluation purposes;
• early identification, screening, and assessment services;
• health services necessary to enable the infant or toddler to benefit from the other early intervention services;
• social work services;
• vision services;
• assistive technology devices;
• assistive technology services; and
• transportation and related costs.

Early intervention services are provided by qualified personnel, including:

• special educators;
• speech-language pathologists;
• audiologists;
• occupational therapists;
• physical therapists;
• psychologists;
• social workers;
• nurses;
• registered dietitians;
• family therapists;
• vision specialists, including ophthalmologists and optometrists;
• orientation and mobility specialists; and
• pediatricians and other physicians.

Children who are deaf or hard of hearing need their language and communication needs addressed as early as possible.  Many parents find that early intervention services help them acquire the skills they need to support their child’s development and help their child meet his developmental milestones.