Marina: Hello everybody. Thanks for joining in on this session, and I am excited to see so many participants. I have worked in early intervention, in the schools, and in a clinic setting. Early intervention is one of the areas that I really enjoy. I like that it is family-oriented, and not just child-centered. I think when it comes to occupational therapy it is important to have everybody involved on board.
Introduction
This talk is about early intervention and fine motor skills. Sometimes for the younger kids this can be a little bit trickier so I want to review how I have worked on fine motor skills and what I have seen. I will go over some ideas and strategies and look at some of the research that is involved. Finally I will talk about some fine motor milestones.
Early Intervention
Overview
Early Intervention is Part C of IDEA, which was established in 1986. There are some other sections of that, but Part C is the one that addresses early intervention. It is to decrease the effects of disability starting from the time that you are born until you are three. This was an area that was often overlooked in the beginning, especially with infants. The thought was, "They are babies, what can they do?" However, there is a lot of research behind the early intervention initiative and it is working. The earlier start that you get, the better off you are in the long term.
5 Developmental Areas
Services focus on 5 developmental areas.
- Physical Develpment
- Cognitive Development
- Communication
- Social or emotional development
- Adaptive development
The first one, physical development, is typically where fine motor would fall. Many aspects of occupational therapy and physical therapy would fall under this first area. However, I like to stress that I feel like all of these things overlap and are intertwined. To look at one area without the others is not being fair to the families and the children we treat. The other areas are cognitive development, communication, social or emotional development, and adaptive development. Social development is often overlooked or is last on the list. We are so concerned about what the kids can do, but what are they able to do in a group setting? What can they do with their peers and their friends? What can they do as part of their families? Fine motor skill development goes hand-in-hand with sensory and emotional development. Thing like preventing meltdowns or advocating for themselves are important things.
Natural Environment
Services can occur in many different places, but they really put a heavy emphasis on the natural environment. That is actually a legal requirement. Who does not feel more comfortable in their natural environment? For a lot of these kids, it is their house and sometimes their daycare. Treatment just makes sense to do in their natural environment. They feel comfortable, relaxed, and motivated in a familiar setting.
The assessments are free of cost to the families, after that services and eligibility are determined at a state level. In the State of Connecticut, they have a sliding scale of fees for service depending on income. At one point birth to three service were provided free of charge, but now it has shifted to a model where there is a financial requirement from families.
OT's Role in Early Intervention
I found this quote from doing my research for this webinar.
Occupational therapist’s “recommend strategies for adapting the environment or daily routines to accommodate the child’s special needs and activities to promote the child’s functional performance” (Edwards, Millard, Praskac, & Wisniewski, 2003).
Here is another:
When the child is close to reaching school age (age 4) the role of the Occupational Therapist is to “improve fine motor skills, with particular emphasis on eye hand coordination and manipulation; to enhance play skills; and to increase self care function.” (Case-Smith 1994)
The occupational therapist's role is to adapt to the environment, or the daily routines, to accommodate the child.
