Health Planning Council of Southwest Florida

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For Southwest Florida Providers

The Early Steps Approach: An Overview for Providers

Early Steps uses a team-based primary service provider approach to early intervention services. This approach is based on research that shows:

  1. Daily interactions between parents or caregivers and their children have the greatest impact on child development. Early Steps providers respect the important role parents and caregivers play in early child development. Providers use a parent education approach to coach parents and caregivers on ways they can support their child’s development during everyday interactions.
  2. Children learn best during the activities and routines that they experience every day where they live and play. Early Steps providers serve families in the home, as well as in childcare centers and community settings typical for children. This provides children with a context for the skills they learn and helps parents see routine daily activities like meal times, playtime, bath time, bedtime and outings as opportunities for their children to practice important developmental skills.
  3. Early intervention services are most effective when provided in the least intrusive manner. A primary service provider is identified to serve as the principle point of contact between program staff, family members and other caregivers. By coordinating services through a primary service provider, families have access to a wide range of expertise without having to juggle multiple appointments with a variety of providers. This approach results in less disruption of daily family life.

The Early Steps Approach

The more providers a child sees—and the more services that are provided—the greater progress a child will make. Research shows a direct relationship between increased child and family services and decreased personal and family well-being, as well as decreased family functioning. Families are more satisfied with services and children achieve better outcomes when services are coordinated through a single provider and provided at an intensity that is responsive to the child’s needs and the family’s concerns and goals.
The primary service provider approach forces providers to practice beyond the scope of their professions, crossing legal and ethical boundaries. The primary service provider receives coaching from providers in other disciplines, and then coaches the family and other caregivers to use jointly-developed, discipline-free strategies for promoting child development through real-life activities in everyday settings. No professional practice act excludes consultation and training of others as a part of valid practice. In fact, many practice acts include these as stated elements of best practice.
Parents and caregivers are expected to provide therapy for their children in place of professional therapists. Parents and caregivers actively participate in the development and use of ideas to help their child learn and grow as a natural part of family and community life. Family members and other caregivers are only performing activities taught to them by a therapist, not providing direct therapy.
Clinics are best suited to providing state-of-the-art services. Services in the natural environment sacrifice quality. New research shows that today, state-of-the-art services are most often provided in natural environments. Research has also demonstrated that infants and toddlers served in home, childcare and community settings are more likely to apply the skills they learn in a variety of contexts compared to those served in clinic-based settings.
The primary service provider approach limits families’ options. The primary service provider approach respects the important role parents and caregivers play in the development of their children. Parents and caregivers make important decisions about the services they want and need and are regarded as equal members of the early intervention team.
The primary service provider approach reduces the frequency of services resulting in fewer opportunities for children to learn and practice important skills. By modeling evidence-based strategies for parents or caregivers to try across various settings and activities
both during and between visits, children experience many more opportunities to practice skills. For example, in a direct service approach, a child may receive one hour of direct therapy a week. However, if that same hour is spent coaching the parent or caregiver on how to support the child’s development across all domains through natural activities such as feeding, dressing, bathing, and play, the learning opportunities for that child are expanded to many more hours per day and days per week.
Parents and other caregivers are not capable of implementing effective early intervention strategies for children. When provided with the necessary supports and resources, all families can enhance the learning and development of their children. In fact, researchers widely acknowledge the value of children’s daily interactions with parents and caregivers; while they have begun to seriously question the value of direct therapy in which parents and caregivers are not involved.
Children with severe disabilities or developmental delays require intensive professional therapy to overcome deficits. The principles of child learning, development and family functioning apply to all children regardless of disability level.
Providers must find ways for parents to fit prescribed therapy into their daily routines. Providers help parents see opportunities for their child to learn and practice skills through existing or desired
activities that are part of everyday life.
The natural environment is just about where the services are provided. Providing services in the natural environment is not only about where, but how services are provided. This approach uses coaching methods which require providers to teach parents rather than treat children. Effective coaching includes joint planning, observation, action/ practice, reflection and feedback.