While the preferred setting for Early Intervention services is the child’s home environment, PIC recognizes that flexibility is sometimes necessary. Services may be provided in child care settings when the child spends a significant portion of the day there and when family members are unavailable for visits during regular business hours.
However, providing services in child care is considered an exception rather than the norm. These settings often present challenges, including environmental distractions, inconsistent caregiver participation, and limited opportunities for carryover of intervention strategies from child care to the home environment.
Due to these concerns, PIC providers may deliver services in child care settings only under specific conditions and with clear parameters. For the purposes of this practice, "child care" refers to any group setting where the child is cared for by someone other than their parent or guardian.
Consider the concerns about serving in childcare prior to planning with families
The following observations have been made by PIC providers about delivering services in childcare:
- sometimes we are serving children in childcare for the convenience of the parent, rather than where the demonstrated need for the child is
- services are not consistently delivered with a coaching model approach in childcare, since they do not include the childcare provider who is busy caring for multiple children
- the childcare provider may not be the full-time carer/may be a substitute
- other primary caregivers/parents are not present, so they don’t they get the actual experience or practice of the interventions even though it is shared with them by PIC providers by email or phone, or through the caregiver.
- PIC providers may have very little time with the childcare provider, and, usually only connect after seeing the child and providing treatment
- many providers report that there is little carryover of treatment due to the circumstances above
- Some PIC providers have delivered services in larger childcare settings by “pulling children out of the class” so that the child and provider are not overwhelmed or interrupted by the other children who want to join in. It should be noted that this is not acceptable practice under child care licensing regulations and not consistent with coaching. Providers work with parents and caregivers to address how we can meet their child’s treatment needs. The most effective treatment for children under the age of three occurs with the people who know and live with them and, within daily activities and routines. If the parent needs to meet us at childcare, or there are no other options and there is a caregiver available at childcare who can attend sessions there, PIC providers may decide to initiate session at childcare. PIC providers are encouraged to be creative and are aware that we must connect the adults who have the primary relationship with the child when delivering services. An exception to this practice is the circumstance where the childcare is run by the parent who is present and available for intervention.
If childcare visits become a priority for meeting the child’s needs, providers will consider the following with the family:
- Since PIC requires a primary care giver (a parent/guardian or a consistent care giver) to be present to support the visit: can a parent/guardian attend the session in the childcare?
- Will the childcare commit to having the teacher present for the entire session, or most of the session for coaching purposes in the childcare?
- Is childcare a primary place where the child’s intervention needs are best addressed?
- What is the carryover plan for both settings?
- How will effective communication occur between settings?
Then, if the only place and time a child can be seen is in childcare, PIC providers will consider the option and decide with the family and the caregivers to provide services in this setting if there is:
- a parent/guardian and/or a dedicated childcare provider is present for the visit,
- a plan for intervention is in place
- a communication plan with carers and parent/guardian.
PIC provider discussed with manager providing services in childcare because:
- child care is where the concern occurs,
- parent/guardian and/or a childcare provider is present for the visit,
- a plan for intervention is in place and includes: (ie, visit every other session in parent home, and emailed intervention),
- there is communication plan with carers and parent/guardian
Sample plans include:
- PIC provider will offer 50% services in the home and half at childcare because the care provider will be present for the session in the childcare, and there is a carryover plan to other providers. PIC provider will check in by phone, email or text with parent and home visit to support carryover, or at next visit with parent.
- Services will be provided at childcare and PIC provider will meet with the parent/child at childcare for a portion of each session.
- Care provider, Parent and PIC provider will meet once per month in the childcare for visits, and PIC provider will meet with the care provider and child an additional one time per month
- Parents can attend by Zoom for meetings 1 x per month and in-person at the childcare center in the early morning, and childcare provider will be present for 30 minutes of each session.
Referral: The preferred location is in the child’s home with a parent present as an active participant. If visits have to be in childcare, it is under certain circumstances that are discussed with the manager first. If a parent is asking for childcare visits, the parent or guardian will be asked to be present for those visits, and with the consistent caregiver in the childcare. Evaluations will have to be in a dedicated space, if at childcare. If the problem is only happening in childcare, we will make sure to look at what is happening there.