Understanding the Role of the Childcare Provider in Early Intervention

In the following guide, learn about the significant role of childcare providers in Early Intervention for young children. We will define Early Intervention and explore the critical role of childcare providers in both referring to and participating in Early Intervention for babies, toddlers, and preschoolers. Keep reading to find out more.

What is Early Intervention?

Early Intervention (EI) is a system of services of specialized support for qualifying children from birth to age 3 who have developmental delays or disabilities in one or more of the following areas of child development:

Physical skills (crawling, walking, reaching, building, drawing)
Cognitive skills (thinking, learning, problem solving)
Communication skills (talking, listening, understanding others)
Self-help or adaptive skills (eating, dressing)
Social or emotional skills (playing, interacting with others)

All U.S. states offer Early Intervention services, but EI programs differ from state to state.

In order for a child to qualify for Early Intervention in most states, he or she must have either:

A developmental delay, or
A specific health condition that will probably lead to a delay, including certain genetic disorders, birth defects, and hearing loss

In some states, children may qualify for Early Intervention services if they are at risk for a developmental delay because of factors such as low birth weight, drug exposure, and other environmental issues.

The Early Intervention program is voluntary for families and serves to provide support and resources to the family and other caregivers in order to help the child meet developmental milestones, learn, and grow through every day opportunities.

Here are the steps in the Early Intervention process:

Referral – A healthcare provider, childcare provider, or family may refer a child to Early Intervention for an evaluation if there is concern about a developmental delay or disability.

Intake – A service coordinator from Early Intervention will share information about the program, collect information about the child and family, and begin identifying the child’s and family’s strengths, needs, and resources. The service coordinator will then schedule an evaluation based on the family’s concerns.
Evaluation and Assessment – The evaluation will be conducted at the child’s home or other natural environment by at least two evaluators who will assess the child’s developmental strengths and challenges. Eligibility for the program will be determined.
Planning – If the child is eligible, an Individualized Family Service Plan (IFSP) will be developed to identify meaningful, functional outcomes for the child and family, as well as the services that will help the family achieve those outcomes. The frequency, intensity, and location of Early Intervention services will be determined.
Intervention – Family, caregivers, and interventionists will work together toward the goals outlined in the IFSP both at home and in childcare settings that are common to the child.

A child participating in the Early Intervention program may receive one or more of these services:

Speech and language therapy – Used to treat speech delays and disorders in order to improve a child’s communication and language skills
Occupational therapy – Used to help children with physical, cognitive, or sensory disabilities to perform everyday tasks, such as getting dressed and self-feeding
Audiology and hearing services – Used to diagnose and treat children with hearing disorders
Assistive technology services – Devices, adaptations, or equipment that help a child with a disability to fully participate in their community
Physical therapy – Gentle exercises and other physical treatments that help children with physical limitations improve their strength, flexibility, and range of motion
Nutrition services – Ensure that children with disabilities have access to nutritious meals
Family counselling and education – Help the family understand the child’s diagnosis and trains them on strategies for communication, skill building, and managing behavior
Psychological services – Assess a child’s condition using tests, interviews, and behavior observation and helps the child learn how to cope with their condition through therapy/counselling
Medical services – Provide specialized medical care related to the child’s condition, such as cardiology, ENT, hematology, and neurology
Nursing services – Provide home-based care and support for children with developmental disabilities, such as Down syndrome, epilepsy, and cerebral palsy

As you can see, Early Intervention services for young children are quite comprehensive and are designed to help children with developmental delays or disabilities meet milestones and grow and develop healthfully with their diagnoses.

In the next section, we will take a look at the childcare provider’s two critical roles in Early Intervention: referral and participation.

The Childcare Provider’s First Role in Early Intervention: Referral

As a childcare provider, you play a significant role in observing the growth and development of children in your care and are therefore uniquely positioned to both recognize potential signs of developmental delays and disabilities and refer families to Early Intervention services.

Familiarize yourself and your childcare team with early child development milestones. We have included a link to the CDC’s milestone checklists in the resources section of this blog post. Learning age-based milestones can help you recognize children who may be falling behind in one or more areas of development and intervene in order to help them benefit from the services of the Early Intervention program.

Although not a comprehensive list, here are some signs that may indicate developmental delays in children:

Delays in rolling over, sitting up, crawling, and walking
Difficulties with fine motor skills
Trouble with understanding what others say
Trouble with talking or talking late
Difficulties with social skills
No eye contact
Problems remembering simple instructions or multi-step directions
Weak muscle tone, such as floppy arms or legs
Vision or hearing problems
Behavioral issues, such as frequent temper tantrums, defiance, or getting angry or irritated very easily

If you do observe signs of a potential developmental delay or disability in a child at your childcare center, then you will want to bring your concerns to the attention of the child’s family.

Here are some best practices to keep in mind when approaching a family with concerns about their child:

Remember that when you bring up your concerns, this may be the first time the family is hearing about them. Emotions may run high, so be sure to be caring, respectful, and supportive during your initial conversation and throughout the referral process.
Remember your active listening skills and be open to questions, comments, and concerns from the family as they process the information you have shared.
Encourage the family to speak with the child’s pediatrician, and give them the contact information for your local Early Intervention services.
Be sure to set a positive tone to the conversation and highlight the child’s strengths and positive qualities.
Be mindful of cultural differences.
Follow up with the family to offer ongoing support and monitoring of the child’s progress.

What if a family does not want to act upon the concerns you bring up to them? As a primary referral source, childcare providers are required to refer to Early Intervention. Naturally, it is better to give the family the first priority in taking the lead on the referral, but if they do not, then you can and should contact EI on behalf of the child. Remember to take these steps with tact and respect for all involved.

Your childcare center should have policies and procedures in place for recognizing signs of developmental delays and disabilities, speaking with families about the concerns, and initiating a referral to Early Intervention services. This way, your childcare team will be on the same page when it comes to handling referrals. You can share these policies and procedures with families when they join your childcare center and if a referral to Early Intervention services becomes necessary.

Next, we’ll explore the childcare provider’s second important role in Early Intervention: participation.

The Childcare Provider’s Second Role in Early Intervention: Participation

For children who have been accepted into the Early Intervention program, you can best support them as a childcare provider by participating in all Early Intervention services they receive, as needed.

As we have discussed above, Early Intervention takes place in the child’s natural environments, including the childcare setting. Interventionists may provide services during the natural course of the day at your early learning center. Their job is to help the parents and caregivers support the learning and development of the infant or toddler in the program through everyday activities.

As one of the child’s caregivers, your participation in the program plays a critical role in providing the consistency they need to meet their individual goals.

Here are some ways you can work together with the EI provider at your childcare center:

Collaborating in the classroom/setting where the child naturally spends time
Identifying and practicing using intervention strategies with the child during typical routines
Sharing ideas about what goes well, problem-solving what didn’t go well, and discussing what assistance you need to support the child
Creating a plan for what you want to try with the child between visits
Communicating with parents about EI visits at daycare
Discussing your observations of the child and his/her needs in your setting
Asking and answering questions
Celebrating the child’s progress

We hope this guide to Early Intervention and the critical roles of referral and participation childcare providers can play throughout the EI process will be an invaluable resource to you and your team.

Take a look at the following section for links to additional resources for childcare providers regarding the Early Intervention program.

Resources for Childcare Providers

CDC’s Developmental Milestones

CDC’s Developmental Milestones – Digital Online Checklist

CDC’s Milestone Tracker App

CDC’s Watch Me! Celebrating Milestones and Sharing Concerns, free online training course for early care and education providers

CDC Guide Tips for Talking with Parents about Child Development

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