I work in an Early Intervention Program here in Boston. This is actually a federally funded program and is found in most states in the US. I work in a program that happens to be connected to Children's Hospital Boston, and it is a fantastic experience. Here are some facts (I'm going to pretend I'm being interviewed...bare with me):
Who do you work with?
Kids ages 3 and under (yes, little little babies!) and their families (that part is very important!)
How do kids get in the program?
ANYONE can refer a child to be evaluated by an early intervention team. We mostly see pediatrician and parents referring because they are worried about some area of development: social, cognitive, motor skills, communication. Once an early intervention center has been contacted, the family will meet with a team of varied specialists (developmental specialists, speech pathologist, occupational therapist, social worker, etc) for an evaluation. I think each state has their own criteria on how kids can qualify for services, but the general gist is that if they fall below a certain percentage relative to their age, they will qualify for services.
Who pays for the services?
The government subsidizes much of the cost of early intervention. Insurance companies are billed, and most companies cover costs. There is also a one time fee for services based on income. These fees are generally really really low, and lots of families don't pay anything at all. At least here in Massachusetts.
So, what kind of things do you work on?
Most kids will not qualify for services based on speech problems (not being able to say certain sounds). Most of the work I do is working on language skills, or even pre-language skills. This may include working on getting kids to imitate, or creating language "rich" environments (parents who talk to their children at a level that is appropriate for their age, but also give them opportunity to talk or communicate back). I teach a LOT of sign language for kids who are having a hard time getting words, and may be getting frustrated. I also work on play skills....progressively more complicated types of play directly correlate with language ability....interesting, huh? For younger kids, I also work on feeding issues (extreme pickiness, not able to cordinate a suck/swallow, etc).
How do I know when to refer a child?
I can only speak for speech/language/communication, but these are my general guidelines on when you might want to talk to your doctor or perhaps call up an early intervention near you:
(**DISCLAIMER: a child who might fall into these categories does NOT imply or mean that something is wrong with them or they have some kind of diagnosis. They just may benefit from a little extra support! See my "Does EI work?" question below :))
Under 1 yr: you should be hearing lots of babbling with different types of sounds.
18 months: kids should be building a vocabulary with different kinds of words (nouns to label, and possibly others like "up" or "no!")
24 months: there should be a big increase or "spurt" in language around or just before this time. Kids should be putting two words together in new ways.
But really.....playing?! Does EI really work?
Why yes...I'm proud to say that there is TONS of research to support early intervention both for remediation for particular conditions but also for prevention of problems like reading or learning disabilities.
After nearly 50 years of research, there is evidence--both quantitative (data-based) and qualitative (reports of parents and teachers)--that early intervention increases the developmental and educational gains for the child, improves the functioning of the family, and reaps long-term benefits for society. Early intervention has been shown to result in the child: (a) needing fewer special education and other habilitative services later in life; (b) being retained in grade less often; and (c) in some cases being indistinguishable from nonhandicapped classmates years after intervention.
Disadvantaged and gifted preschool-aged children benefit from early intervention as well. Longitudinal data on disadvantaged children who had participated in the Ypsilanti Perry Preschool Project showed that they had maintained significant gains at age 19 (Berrueta-Clement, Schweinhart, Barnett, Epstein, Weikart, 1984). These children were more committed to schooling and more of them finished high school and went on to postsecondary programs and employment than children who did not attend preschool. They scored higher on reading, arithmetic, and language achievement tests at all grade levels; showed a 50% reduction in the need for special education services through the end of high school; and showed fewer anti-social or delinquent behaviors outside of school. Karnes (1983) asserts that underachievement in the gifted child may be prevented by early identification and appropriate programming.
I think EI is one of the greatest things our government has to offer! And unfortunately I don't feel like enough people know about it or recommend it....pediatricians included. So the moral of the story is: if you know someone that might benefit from EI, please encourage them to find the EI center for their state!!
I have lots of soap boxes when it comes to my profession, so I will end now :)
