Our Experience With Early Intervention Home Visits

This is Part Two on the topic of Service Providers.  Part One is "Orion's Service Providers Resumé".

Back Then: Orion shows off at the Kendall Parent-Infant Program room.
(Sometime during February-April 2011, Orion is  7 to  9 months old.)
Photo thanks to Kendall PIP teachers!

We have experienced a few different early intervention (birth to 3) home visit set-ups here in Texas and back in Maryland: a visit by a single service provider, a visit by two service providers, a visit by three or more service providers.  In my case, because we require an ASL interpreter to communicate, an interpreter will be there at these visits.  A few service providers knew sign language so an interpreter was not necessary.  Occasionally, the state Deafblind project technical assistance person (for birth to 5 years old deaflbind kids) will come to our home or see Orion at school.  They have always brought valuable insight and tips for those who work with Orion!

Single service provider visit: one-on-one with Orion.  My view on this is that it maximizes his time with the service provider for the amount of time documented in his IFSP (example: 30 minutes once a week).

Paired visits (2 providers):  The amount of time with whatever service can get fuzzy here, for example, is it truly 30 minutes from one provider and 30 minutes from the other? However, I feel it is balanced by the teamwork and cross application of skills and knowledge in their specialties that Orion benefitted greatly.  One beautiful example of combined specialties is speech-language teacher ("SLP") and occupational therapist (OT) doing a language and fine motors activity with Orion. The activity was snack time with self-feeding being the OT's bag; offering choices and modeling tactile signs or touch cues being the SLP's bag).

The two providers (4 eyes together) observed and shared their findings, musings and their professional knowledge with one another and bounced ideas off another.  Everyone benefitted here.

Party! 3 or more providers:  This is what Orion had in Maryland, all of the providers would show up together, along with the interpreter for an hour and be gone on their way.  It is very similar to the paired visit that I described above but four was a party.  Yes, everyone benefitted.  We did see teamwork, learning, insight, observations, sharing of professional knowledge.  The downside is if you break down the numbers, four professionals in an hour means 15 minutes each provider.  That doesn't seem to be enough time.  If you're not comfortable with this, you need to bring it up and see about truly following the time documented in your child's IFSP.

Occasionally there would be scheduling challenges for that number of people but I certainly welcomed the visits by those who could make it and those individual make-up visits.

Frequency of Home Visits

Orion started out with a "party" visit every two weeks as an infant; we soon increased that to weekly "party" visits.  I can't recall when. Maybe it was at a 6-month IFSP review or annual review.  I know you can ask anytime to schedule a meeting to discuss changes to your child's IFSP or IEP.  Some service providers may only come out 2-3 times a month (for Orion it was usually the PT/OT who came out 3 times a month), it depends on you and the team's discussion during the IFSP meeting. (This does not include Orion going to Kendall School PIP twice a week.)

During the home stretch of Orion's last year in ECI, (not including Orion going to TSD 3 mornings a week for D/HH or vision services) we would have weekly home visits from the OT/SLP and then the PT, and a home visit once every two weeks by O&M.

This also does not include ER visits, medical appointments and therapy appointments (through insurance) we needed to go to!  Thankfully those medical visits have reduced in number.  We are currently waiting to start OT and PT visits covered by insurance, separate from the school services.

Team Meetings

This was one of my favorite things to do with Orion's "Austin" IFSP team, monthly team meetings!  I'm always with Orion for his home visits.  Well... 99% of the time!  But Orion's service providers can't do that.  This is where team meetings are extremely helpful and insightful.  People can touch base on what each person is doing with Orion; learn something new that Orion has been doing that they were unaware of; the PT can tell the whole group about a technique they can incorporate for Orion's activities to be beneficial in a multi-faceted way.  Think about the input and insight the lone service provider gains and contributes at these meetings!

The vision consultant and O&M has shared with the group the needs of Deafblind children in a way that providers can connect better with Orion, learn what resources and strategies that have been used with other Deafblind children and sort out what is a Deafblind/information gathering issue or what is a physical issue. For an an example: Orion does not walk.  It is not because he is weak but because he hasn't seen people using their legs to walk around, thus he's missing the curiosity and motivation for him to try to walk and develop the strength his legs need.

...and chocolate therapy!
(Sometime during his 2nd of 2 years at Kendall PIP,
photo thanks to PIP teachers!)

Too Much Therapy?

Crazy, huh?  No doubt it caused stress for everyone in our family in different ways.  The other option of dialing it down and Orion having occasional therapy, to me, is unacceptable.

It is work, it is a work of love.  I believe we need to include everyone else in our family with Orion.  Not just "Orion and I" or "Orion and Daddy".  We need to make sure to play with Orion, make him laugh every day because not only it is good for him, it is good for us, too!

If there is a way for you to include family members in therapy (and family play time), everyone wins!  If others see how the OT or PT works with your child, they will be empowered and comfortable doing OT/PT "homework" with your child.  The SLP or D/HH teacher, in her work, models tactile sign language or touch cues that others can pick up on and use comfortably with your child.  Skyler likes to play rough with Orion and since he also has seen some PT visits, he would make Orion stand and sit.

So, with as many family members involved and sharing in the moments and fun, it's all worth it.  (We don't have everyone we want involved. :P There's a couple grandparents, aunts, uncles and cousins who aren't nearby.)  I'm not the only person in the family who celebrates Orion's little accomplishments!