Therapy Services in Early Intervention

Abstract

The purpose of this study was to determine (a) the major challenges in providing specialized therapies to infants, toddlers, and preschoolers with disabilities; (b) what models of service delivery are used and why;(c) what makes the provision of therapy services go well; and (d) what strategies are used for overcoming barriers to effective services. Focus groups were conducted with early intervention therapists, nontherapist professionals, administrators, and parents. Results showed that a shortage of pediatric therapists and policy/administrative constraints caused services to be of lower quality than desired. We also found that concepts of "needing" therapy were muddled and that most people said that "more is better" as long as the quality is high enough.Children with disabilities or who are at risk for disabilities often require intervention in motor and communication development, so occupational therapy, physical therapy, or speech-language therapy are frequently involved. Early intervention services also consist, however, of "generalists" such as early childhood professionals (e.g., early childhood teachers) and other nontherapist professionals (e.g., early childhood special educators, social workers). Furthermore, families are key players as members of their child's intervention team through both informal and formal activities. This study explores stakeholders' perceptions of therapy and the capability of the current number of therapists to meet the demands for therapy. Shortages of occupational therapists, physical therapists, and speech-language pathologists have been documented in terms of the estimated numbers required to serve the numbers of children needing services (Yoder, Coleman, &cGallagher, 1990), in terms of current vacancies (Council for Allied Health in North Carolina, 1994), and in terms of the numbers needed to form essential team configurations (Wolery et al., 1994). Even if existing vacancies were to be filled, however, it is unknown whether, according to families' perceptions, the need for specialized therapies would be met (McWilliam et al., 1995; Sontag & Schacht, 1993). Research on professionals' perspectives on therapy services is scant. Among school-based professionals, opinions of and knowledge about related services have varied (Giangreco, Edelman, &c Dennis, 1991; Tomes &c Sanger, 1986). The literature suggests mixed reactions of families to therapy services. In general, families have been found to place great importance on therapy (Hinojosa, 1990; McWilliam et al., 1995; Sontag St Schacht, 1993). They have also reported wanting therapy services to be more child and family centered-less rigid and therapy centered (Lawlor &c Cada, 1993). Early intervention therapists can provide services in many ways. Beyond simple distinctions of setting (home, classroom, office, hospital), therapists can be more or less directive with parents, can work in general classrooms or in separate therapy rooms, can include or exclude parents in therapy sessions, and can work with others or alone in execu...

Metanoia en Atención Temprana: Transformación a un Enfoque Centrado en la Familia

“…El campo de estudio ha reconocido desde hace mucho tiempo que el modelo médico no era adecuado para la atención temprana (Hanft, 1988;McWilliam, 2014b;McWilliam, Young y Harville, 1996).…”