OT & PT in Early Intervention

In Iowa, early intervention services are called Early ACCESS for Children and Families. The partnering agencies for Early ACCESS are the Iowa Departments of Public Health, Human Services and Education and Child Health Specialty Clinics.  

Early ACCESS services include any of the following areas: assistive technology, audiology, family training, health services, medical services, nursing service, nutrition services, occupational therapy (OT), physical therapy (PT), psychological services, respite care, social work services, special instruction, speech/language pathology, transportation and related costs, vision services and other early intervention services. Occupational and physical therapists are members of multidisciplinary and multi-agency teams. Meetings include early childhood child study team meetings, family team meetings and interagency team meetings in addition to IFSP meetings.  

For children in Early ACCESS, the concept of conducting general education (Step B) interventions prior to evaluations is not applicable (step Bs). When screening results indicate a possible motor delay, an OT or PT will do further assessment. This is best done in the child's natural environment – home or day care. Assessment information may be gathered through medical history, past or present therapy services, parent/caregiver interview, developmental evaluations, or clinical observation of the child in their natural environment. It should be noted that standardized tests are not always used by the OT or PT. In many instances, normative data does not exist for individuals being evaluated by the therapists.

Areas of OT/PT assessment include developmental motor levels (gross and fine), oral motor, neuromusculoskeletal systems and functional motor skills including mobility, positioning, play skills and handling techniques used by the therapist and family. Present levels of performance and goals are documented on the IFSP and in a report. Frequency and mode of service are determined by the IFSP team, which includes the family. Service delivery options include direct, integrative and consultative models. Services are available to the family year round

Children 0-3 in Early Access

An intake is initiated by a phone call to the Early ACCESS secretary with a concern regarding a childe age birth through 2 years.  It is then given to the appropriate Early ACCESS Service Coordinator (SC) who makes contact with the family within 48 hours after the original phone call to arrange a time to meet with the family.

Under Early ACCESS, the SC and the family review the family priorities, needs and current concerns about the child as well as information from previously completed evaluations.  An Individual Family Service Plan (IFSP) will be begun, if the family wants to proceed with assessment and service.  Areas still needing to be evaluated will be determined and the SC will assist the family in planning for these.  Assessments must include the areas of health, communication, physical (including hearing and vision), cognitive, social/emotional and adaptive.  An occupational (OT) or physical therapist (PT) may assist with these initial evaluations of the child's development or be called in later when a concern arises in regard to motor development.  Initial evaluations and determination of service needs must be completed and the IFSP conference held within 45 days from the original phone call.  An IFSP must be reviewed once a year and documentation updates made at least every 6 months.

If the child is at risk for future motor problems secondary to a specific diagnosis or presents with a 25 percent or greater delay in motor development, OT/PT services may be provided through an IFSP.  The frequency of service is based on the child's needs, professional judgment and parent input.

Children 3-5 at Home or Pre-school Based

For concerns regarding a child age 3 years old to school age, an initial intake form is generated by a phone call to the Early Childhood secretary.  It is then given to the staff member whose area of expertise relates to the primary area of concern.  If assessment indicates a child is eligible for services and the family agrees, IEP procedures are followed. If a child's needs indicate that assessments in other developmental areas would be appropriate, a referral to those early childhood disciplines is made.  The assessment results and recommendations are used to develop the IEP.

Frequency of OT/PT service is determined by the IEP team which includes the parents.  Service delivery options include direct, integrative and consultativemodels.  Services are delivered at  home, daycare, private preschool or Headstart programs or a combination of the above. Services are provided throughout the school calendar year.