Early Intervention During COVID: What You Need to Know
Of all the ways COVID has affected our lives, there are some less visible changes that may be detrimental to our kids’ development. Earlier this year, Disability Scoop reported that referrals to early intervention programs and related services have plummeted as a result of COVID; the article focuses on New Hampshire, but the numbers are down nationwide. In the Los Angeles area, early intervention referrals are down about 25 percent, which mirrors the downward trend throughout the state.
But what many parents might not realize is that early intervention services never stopped — they’re just taking place virtually, and they’re still effective and essential. Unlike other virtual services, young children don't have to sit in front of a screen; parents can share videos of their child in the home environment with therapists and other service providers.
To find out more about how families can get back on track with early intervention, we spoke with representatives from the Westside Regional Center, the Infant Development Association of California, and the UCLA Intervention Program.
What Is Early Intervention?
- Early intervention (or Early Start, which is the name of California’s program) is administered through the Department of Developmental Services and the Department of Education.
- Twenty-one Regional Centers in California offer early intervention services — which include speech and language therapy, physical and occupational therapy, hearing and vision services, and more — free of charge for families with children ages zero to three.
- To be eligible, children must be evaluated and determined to either have a developmental delay or a specific health condition that will likely lead to a delay.
- For more information about early intervention, call 1-800-515-BABY (2229) and select the “Early Start” extension number.
When Should We Seek a Referral (and From Whom)?
- Starting services early is always the best course of action. Tom Kelly, Director of Clinical Services at Westside Regional Center (WRC), says he sees a lot of parents and providers taking a wait-and-see approach, which is not ideal: “It’s better to refer earlier than later,” he says. “If a child comes in at 32 months, we can only work with them until 36 months, so we’ve lost valuable time. Even if your child isn’t found to be eligible, you get a free global evaluation with specialists who are looking at your child from different angles.”
- Anyone can refer a child to an early intervention program — referrals don’t have to come from a pediatrician or other physician. Parents commonly find out about Early Start from other parents, neonatal units, teachers, daycare providers, and more.
Trust Your Instincts!
“You are your child’s advocate,” says Dane Fitzmorris, Director of the UCLA Intervention Program. “Even though it’s scary, have an honest conversation with your pediatrician and call your local Regional Center to initiate an intake.” Fitzmorris adds that we need to take away the stigma of getting a developmental evaluation, because most of the time, parents’ instincts are correct.
Why the Drop in Enrollments?
According to California’s Department of Developmental Services, the monthly average number of children referred to Early Start was 18% lower in 2020 than it was in 2019.
- School referrals
Westside Regional Center’s Tom Kelly tells us their Early Start referral numbers experienced a 25 percent decrease in 2020: “A lot of kids were referred to us by school districts, and suddenly you don’t have kids in school — you don’t have as many eyes on the child. If your child is at home and not speaking, you might rationalize it as a reaction to the pandemic. All these things combined created a perfect storm.”
Fran Chasen, policy co-chair of the Infant Development Association of California, notes that the drop in referrals is also a reflection of how the pandemic has altered everyone’s lives: “Many opportunities for young parents to interact and see other children at play (such as parks and playgrounds, meet-up groups for new parents, and neighborhood and school activities) aren’t available, so parents might not know what they should be looking for.”
Dane Fitzmorris agrees: “Even if you have a gut feeling, it sometimes takes seeing other kids for parents to feel like their intuition is valid. If you don’t have these opportunities, you may not know what is typical.” She adds that referral numbers to UCLA’s program have dropped significantly during the pandemic.
Challenges of virtual life
Virtual services have also been a barrier for some families. “One of the tougher areas is acclimating families to virtual services,” says Niaisha Gonzalez, WRC’s Early Start program manager. “It takes teamwork, with parents being as hands-on as possible.”
How Do Virtual Early Intervention Services Work?
- Early intervention services are typically provided at home, in a clinic, or — as with center-based programs like UCLA’s Intervention Program — within a classroom setting. But when the pandemic hit, most services became virtual. Fitzmorris tells us that UCLA examined their program, pulled out the pieces they felt were most important, and transferred them to a virtual setting. (Now that COVID cases are decreasing, small in-person classes will begin, though parents can still choose to continue virtual services.)
- In UCLA’s program, the minimum requirement for toddlers ages 18 to 36 months was to be in a classroom setting for three hours a day, three days a week, Fitzmorris explains.
- “There is no way a young child can be on Zoom for three hours a day, so we ask our parents to log in from 9:00 to 10:45 a.m. Monday through Friday. We send families our materials and a calendar of what we’re going to do every day; the emphasis is on consistency, structure, and opportunities for practice. Most of our activities use items that families tend to have around the house, so they don’t have to buy anything special or feel overwhelmed. They also have an hour of 1:1 time once a week with the teacher, and a parent support group on Wednesday afternoons.” Fitzmorris adds that young children are never expected to sit in front of the screen; they are free to move around during the sessions.
The Unexpected Virtual Benefits
- While virtual services have been difficult for many people, Chasen points out that many others have benefited, and many therapists will likely continue to offer a virtual option even after things return to “normal.”
- “Telehealth is a tool,” Chasen says. “Parents can get help through phone calls, videos of the child, having the camera on to observe general play and what happens at bedtime — all of these can help us figure out what’s happening at home. It’s important that parents know there are supports out there so they don’t feel so alone, and so they know that kids can still grow, learn, and have fun.”
- WRC’s Niaisha Gonzalez agrees. “I really appreciate that families are implementing the strategies — in the beginning, it can be a lot. We also talk about how to take time for yourself; it’s okay not to be superhuman!”
What to Look for in a Provider
Of course, just like with in-person services, not all virtual therapy is the same. “Sometimes there’s a connection with the provider, sometimes not,” Fitzmorris says. “Don’t be afraid to explore other options if it’s not working for you. It’s also important to talk with your provider about concerns. Your therapist may be able to give you tips on ways to set up the environment for success. Just like in a classroom or therapeutic setting, the provider needs to find ways to engage the child.”
What if I’m Not Getting the Support I Need?
- Talk to your provider
As a consumer of services, whether those services are paid for by insurance or a Regional Center, you have a right to speak up. “If something isn’t working or you feel your child is regressing, have a talk with the provider,” Fitzmorris says. “It can be hard to see differences over a screen, so make sure the provider is aware of any nuances. Providers rely on parents and caregivers being the eyes and hands because we can’t see everything on-screen.” She adds, “It’s a partnership, and parents should approach it this way.”
- Stay in touch with your RC service coordinator
Gonzalez tells us that if the team recommended one service but the family feels the child needs more, the family should relay that to their Regional Center coordinator. “It’s an open dialog — always keep your service coordinator in the loop so we can work together and find out what you need.”
- If you can, join a pod
Community support is important, too, says WRC’s Tom Kelly: “My advice is to have a parent pod so you have other parents who are going through the same thing and can support you, and you can have a safe pod for your child. Kids need to be around their peers in a safe environment. Even if it’s virtual, create some kind of group. We have to try to mitigate risk and navigate COVID but also be attentive to the fact that the social-emotional impact of the pandemic is great.”
What Should Providers Know?
- Providers should know that services are up and running, Chasen says. “Services may be delivered in a different format, but you can still reach out, check in, and make referrals. Childcare folks have been adjusting too; they’ve been out there and open.” She adds that communication is key: “Providers should check in with other therapists and families to find out how to best help the child.”
- If a provider feels a child needs another service, or if there is a gap in services, providers should bring it up with the family, refer them to their local Regional Center, and include it in their report: “Recommendations from other providers can really help,” Fitzmorris adds.
- WRC is looking at developing an electronic portal to make it easier to make referrals and reach outside providers. Gonzalez adds that their team has reached out to pediatricians to make sure they know they’re open: “You can’t physically come into the building, but you can call, email, and send referrals.”