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Children's Medical Services - Special services for children with special needs
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Module Two: Lesson Three

Integrated Services: Early Steps Policies and Procedures

In the following table, you can see specifically how the Early Steps Service Delivery Policy and Guidance Paper addresses the implementation of EINE Component #3: Integrated Services.

Model Component Specific Practice

#3 Integrated Service Delivery Purposes:

  • To coordinate intervention
  • To reduce burden on the family
  • To increase confidence and competence in staff
  • To use limited resources more efficiently
Team Based Primary Service Provider Model
Early Steps Policies and Procedures
An integrated service delivery system and the practice of using a team based primary service provider approach are essential elements of the Early Steps system. The following passages from the Early Steps Policy provide references to the policy and procedures that guide these practices. There are numerous references throughout the paper to integrated services and the team based primary service provider.

IFSP Development

  1. Identify and write functional outcomes prior to determining services that reflect:
    • routines of the family and individuals involved in the child's development
    • activities that are important to the family (including activities that they currently enjoy, as well as those activities that they would like to do but are unable to participate in due to the developmental delays or disability that their child presents)
    • skills that are essential for the child to attain and that are generalized to a variety of naturally occurring, typical routines that the child is engaged in on a daily basis
  2. The steps and strategies to achieve an outcome are explored by identifying:
    • what will happen in the family's daily routines to support the outcome
    • by whom and in which of the various settings that the child and family frequent can this outcome be practiced
  3. Identify necessary supports and services that are included on the IFSP.
  4. Determine which team members need to be involved (integrated services).
  5. Identify primary service provider and participation of other team members. (p. 39)

The Primary Service Provider

The team based primary service provider model being implemented by Early Steps requires the IFSP participants to select a primary service provider for each child and family. This person can be a therapist, other licensed healing arts professional, EI Provider, or an Infant Toddler Developmental Specialist (ITDS). The primary service provider may also be the designated service coordinator. The decision is made by the participants in the IFSP meeting and is determined based on the presenting needs of the child and family, the IFSP outcomes, relationships with the family/caregivers, and expertise in the areas of support needed by the child and family/caregivers. The same person does not always have to be in the role of the primary service provider and can change based on the changing needs of the child or family/caregivers or the focus of the current functional outcomes being addressed.

It is intended that each provider will interact with all other service providers to discuss progress, areas of need, specific observed behaviors, and how the primary service provider and the other professionals can consistently reinforce certain movements or interactions to further the broad developmental goals of the child and achieve the identified outcomes. If a therapist is the primary service provider and another therapy service provider is providing guidance on the family's use of techniques, it is appropriate for the therapist in the primary service provider role to be knowledgeable of those techniques and activities through consultation and coaching during joint visits. The frequency and intensity of joint visits depends on child and family/caregiver needs. This results in less intrusion into the family, increased communication between team members, and consistency in the implementation of the intervention plan (Shelden & Rush, 2001). (p. 18-19)


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