Working in Early Intervention Occupational Therapy

If you enjoy working with infants, young children, and families, early intervention occupational therapy may be the right fit for you!

Early intervention occupational therapy provides a means for the family and therapist to connect and address the needs of the family and child as a whole. We’ll go into more of what this looks like below.

Typical Early Intervention Settings

Early intervention occupational therapists work in medical settings such as Neonatal Intensive Care Units (NICU), pediatric outpatient centers, and hospitals or clinics. These settings are supported through private funding or other funding sources.

Early intervention occupational therapists can also work as part of a state’s early intervention system as a primary service provider, service coordinator, or as a member of an evaluation team under the Individuals with Disabilities Education Improvement Act of 2004 (IDEA) Part C.

In the NICU, occupational therapists provide direct patient care and consultation for premature and medically complex infants. Much of a NICU OT’s time is spent providing family/caregiver education on the following topics:

• Understanding their baby’s cues
• How to comfort their baby
• How to bond with their baby through skin-to-skin care called “Kangaroo Care”
• The infant’s sensory and motor development
• Safe and supportive positioning and handling techniques
• Strategies for enjoyable feeding experiences
• Safe sleeping practices at home.

NICU OTs also provide information and referrals for therapy resources in the community when an infant is ready for discharge but needs ongoing intervention.

Infants and young children can receive services in a pediatric outpatient clinic through private pay or in a home or community setting through state funded services under IDEA Part C. In both settings, the occupational therapist focuses on the child’s occupations of playing, eating, sleeping, bathing/self-care, and socialization.

Services under IDEA Part C are provided for children from birth to three years old (and up to five years old in some states). Children are eligible if they meet one of the following criteria:

1. Has a developmental delay
2. Has a diagnosed disability that has a high likelihood of causing a developmental delay
3. Is at risk for developmental delay at the state’s discretion.

These services must be provided in the natural environment to the greatest extent possible. The natural environment is defined as a family or community setting that is common for peers of the same age. Visits may occur in the home, daycare, Early Head Start Program, or a community setting such as a park or playground.

Requirements Needed to Go into Early Intervention

First, the most basic requirement is that you need to have graduated from an accredited program and possess national board certification and state licensure. Some states require additional state level certification and/or training to practice as an early intervention therapist. Be sure to check your state-level requirements through your state’s agency.

The second requirement is, of course, having the skills. OTs and OTAs should possess a variety of skills that will apply to early intervention services:

• Knowledge in activity analysis
• Environmental modifications
• Adaptive equipment
• Advanced knowledge of child development
• Advanced knowledge in education
• Knowledge and skills in mental and physical health

If you have not had any experience with early intervention in your OT program or fieldwork, we do recommend taking continuing education courses on this topic before applying to positions. MedBridge Online Continuing Education is our recommended CEU provider which has a wide array of early intervention courses that you can take any time.

If you haven’t signed up yet, you can use our promo code MYOTSPOT for $175 off of your annual subscription. When you use our promo code, we receive a small commission that supports My OT Spot at no additional cost to you.

The Early Intervention Process

The first step of the early intervention process is a referral to the local program. Each state has a referral system for early intervention. Primary referral sources include doctors, hospitals, and other programs. Parents and/or caregivers may also contact the early intervention program directly to determine their options.

Once the family is in touch with the community’s early intervention program, they will be assigned a service coordinator. A service coordinator explains the steps of the early intervention process and serves as the point of contact. Once parental consent is obtained, an evaluation or screening will occur within 45 days of the referral to determine if there is a disability or developmental delay as well as to gather information about the family’s resources, concerns, and priorities.

The multidisciplinary evaluation team is composed of professionals with training and expertise in speech and language development, physical skills, hearing and vision, cognition, and social-emotional development. The evaluation team meets to determine if the child meets state criteria for eligibility for services. Some children may not need a full evaluation if they have a qualifying medical condition.

There are five areas of development the evaluation team examines for eligibility:

1. Cognitive
2. Communication
3. Physical
4. Social / emotional
5. Adaptive

The IFSP – Individualized Family Service Plan

If a child is found eligible for services, an Individualized Family Service Plan (IFSP) is written with the family within the 45 day period as well. The IFSP outlines the families goals and priorities for their child which drives and determines the services the child will receive.

The IFSP team includes the child’s parents, any family members or advocates as requested by the child’s parents, the service coordinator, evaluation team, and the individuals that will provide services to the child.

An IFSP will contain:

• The current levels of developmental functioning of the child
• The family’s concerns, priorities, and available resources for their child
• Measurable goals or outcomes for the child to be achieved
• Types of early intervention services the child needs in relation to their goals/outcomes
• The settings where intervention services will occur
• Any other related services the child will receive

The parent must give consent for the provision of each early intervention service provided by the IFSP. Once the IFSP is agreed upon by the family and consent is obtained, the service coordinator will assist with setting up the outlined services which should be made available as soon as possible.

Core Principles of Early Intervention Occupational Therapy

There are 7 core principles of early intervention. In keeping with these principles, it is important to remain family centered, culturally sensitive, provide intervention in the natural environment, use evidence-based treatment strategies, encourage meaningful participation in occupations, and focus on the family’s capacity and resources as well as their routines and rituals.

These guiding principles will assist you in building lasting relationships with families as well as successful outcomes with the children you serve.

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We hope this quick synopsis helped give you an idea of what early intervention looks like as an OT. If you work in early intervention, please share any thoughts or tips you have for therapists interested in going into this field in the comments below!

Additional References

What is the Role of Occupational Therapy in Early Intervention (AOTA)

Role of Occupational Therapy With Infants, Toddlers, and Families in Early Intervention (AOTA)

Basics of the Early Intervention Process under Part C of IDEA

Work Group on Principles and Practices in Natural Environments, OSEP TA Community of Practice: Part C Settings. (2007). Agreed upon mission and key principles for providing early intervention services in natural environments.

Early Intervention Occupational Therapy: What You Need to Know (Covalent Careers, 2017)