Early Intervention: Interdisciplinary and Interactive

Precariously holding on to a "sippy cup," a 16-month-old toddler offers the occupational therapy student a pretend sip of his juice. He smiles with pleasure as she obviously enjoys the offer. Then he walks over to a stack of blocks placed strategically on the floor by the physical therapy student. He squats down to touch it but knocks it over, imitating the speech-language pathology student's "uh-oh" as the tower goes crashing to the floor.

Collaborating professors Luanne Andersson, Carole Dennis, and Kathleen Schlough

The child is being evaluated for a possible disability or a delay in his development. Even though the evaluation process can sometimes look like an unstructured free-for-all, with toys scattered around the room, cracker crumbs on the carpet, and smiling students and faculty members playing with an adorable youngster, the standardized tests being used can pinpoint the special needs of the child.

The Departments of Occupational Therapy, Physical Therapy, and Speech-Language Pathology and Audiology have teamed up with the Tompkins County Health Department Early Intervention Program to provide evaluation services to infants and toddlers (birth to three years) who may be at risk for developmental delay or disability. The federal
government, under the Individuals with Disability Education Act, mandates provision of such services to qualified children, but there is currently a shortage of qualified professionals who can provide these services. Last fall the Early Intervention Program in Tompkins County approached Ithaca College about the possibility of expanding services at the Sir Alexander Ewing Speech and Hearing Clinic to include core evaluations, because the county thought Ithaca College faculty and students had the expertise to provide a valuable service to the community. The school, in turn, thought this would work well with its mission and would afford its students valuable experience in the early intervention evaluation process.

In Tompkins County children are placed on a waiting list to be evaluated and then, if need is established, to receive intervention services. Referrals for developmental evaluations come from a variety of sources, such as pediatricians, nurses, parents, and community agencies. A child may receive an initial core evaluation from a team of providers, usually consisting of an occupational therapist, physical therapist, and speech-language pathologist, and sometimes a psychologist, educator, or social worker as well. This team then makes an appointment with the family for an evaluation of the child's five key developmental areas: cognition, communication, and physical, social/ emotional, and adaptive (self-care) development.

Evaluations go more easily when there's fun involved.

The evaluations with the IC core evaluation team are scheduled once weekly at the Ewing Clinic or in the family's home. Depending on the history and needs of the child, members of two of the three disciplines do the comprehensive assessment while the member of the third discipline observes; a service coordinator from the Department of Health accompanies the parents and child to the evaluation and acts as a liaison between them and the team, pediatricians, and other health care providers as needed. Faculty supervisors select the students who will perform the evaluation under their close supervision. In the speech-language pathology department, graduate students perform the evaluation under the supervision of assistant professor Luanne Andersson. Graduate students in occupational therapy are supervised by assistant professor Carole Dennis. Senior physical therapy students are overseen by assistant professor Kathleen Schlough. OT major Anna Ehrlich '02, M.S. '03, says, "Working with experienced therapists as well as other students to discover the abilities of a child is an incredible learning experience."

During the evaluations students and faculty learn to work together to best observe the children's performance. Clapping and cheers are commonplace as children warm up to the strange people who bring them toys.

The evaluators make recommendations based on the child's needs and share them with the family. They might suggest further evaluation, specific services, or even no special services at that time.

The evaluation can take two to three hours. In addition, the student/faculty team meets prior to the evaluation to discuss the child's needs and appropriate assessment tools. Following the evaluation, time is provided for a team discussion on how things went and what can be changed in the future. The team then writes the evaluation report about the child's development in the five areas, which is given to the family and then discussed with them at a meeting.

Not only are the students learning to work with very young children and learning new skills, but they are learning to work cooperatively as an interdisciplinary team. The process is time intensive, but it has been a powerful experience for all involved. Physical therapy student Lisa Gradziel '03 says, "This program is a great opportunity for students from PT, OT, and speech to interact as an interdisciplinary team and gain experience that will be beneficial after graduation."