Throughout Izzy’s outpatient appointments, a few of her specialists would always ask, “Are you working with Help Me Grow?” We would respond no, but that we would look into it… and I’m so glad we finally did. For any child with a developmental delay/disability/diagnosis, infancy through the age of 3, who may need physical therapy, occupational therapy, speech therapy, etc., this program is wonderful and I can’t recommend it enough.
Below I have laid out what to expect and the process to get started.
Help Me Grow is an evidence-based system provided through the Ohio Department of Health that focuses on prenatal care, well-baby care, and/or parenting education. Within Help Me Grow there is an Early Intervention (EI) program available through the county. We work specifically with our county’s Board of Developmental Disabilities and our county’s Educational Service Center, but Early Intervention is a statewide system, and the Help Me Grow “umbrella”, if you will, can be found throughout the nation.
The purpose of Early Intervention is to provide services and support for infants and toddlers with developmental disabilities, along with their families. EI is very much family-centered with the belief that children learn best from familiar people in familiar settings. Because of this philosophy, therapy is done either in the home or in a place of comfort for the family, and parents and caregivers work together with the professionals to provide the necessary treatments.
Referral & Qualification:
To get started, you can either fill out a referral form online or have your child’s pediatrician or physician submit a referral. For Izzy, I did it myself, as the form was very easy and straight-forward. You provide your information, what service(s) you are seeking, and why. A link to the referral can be found here –> https://odhgateway.odh.ohio.gov/ochids/public/refer
After I submitted the referral, I received a phone call to set up an intake appointment. Due to Covid, our intake and “paperwork” sessions were held virtually, but typically they would be in-person. In this initial phone conversation, I spoke with a service coordinator and we went over the referral form in more detail. She informed me that this would typically be the point where we would find out if the child qualifies for EI or not, but because Izzy’s diagnosis is a chromosome disorder, she automatically qualifies. All she needed from my end was proof of diagnosis with a physician’s name or signature, so I emailed her a few medical records and we were good to go. It sounded like as long as you have proof of your child’s developmental diagnosis or disability, or if your child’s doctor makes the actual referral, there would be no issues with qualification.
I submitted our referral on January 20th and already had our intake scheduled for February 1st. I love a quick turnaround!
Another thing I loved about all of this was the fact that the service coordinator who called me to discuss the referral and set up the initial appointment was the same service coordinator to do our intake, and she will continue to be our service coordinator throughout our entirety of working with Help Me Grow. The role of the service coordinator is to complete the intake, the assessment(s), the initial IFSP (I’ll get to that), and the IFSP reviews. However, this person is also available at any time you need them – just a phone call or text message away.
As our service coordinator explained, she will always be involved, but after we are given our service provider, that person will transition into the main role. During the intake, we were emailed the Early Intervention brochure detailing what they are and what they’re not. We learned that on a child’s 3rd birthday, Help Me Grow will end but they will connect us to the next necessary step, most likely Izzy’s preschool, where they will “pass the baton” and the school system will then be legally responsible to take over and take action.
We also learned the difference between outpatient therapy and EI/HMG therapy. With outpatient therapy, the therapist works alone with the child in their office setting & then informs the parent or caregiver on what they did. With Early Intervention, the philosophy follows a family-centered approach, aka a “primary service provider model”, which as explained above, is the belief that babies and toddlers learn best from the people they’re bonded to in a natural environment and in their natural, daily routine. So, in contrast to outpatient sessions, EI sessions include the parent/guardian/family, and all therapy is done in the home. The EI model sees that success comes from a combination of their child development expertise + our family expertise. Although EI sessions occur less often than outpatient sessions, each one is longer in length.
With the “primary service provider model”, the goal is to limit the amount of professional providers to 1 or 2 depending on the child’s needs. For example, a developmental specialist might be determined as the sole provider, but then down the road there might be a more specific need for PT or OT, so the developmental specialist would consult with the necessary therapist and they would be brought in, as well.
Developmental specialist: “teacher” – will teach the child the necessary techniques to get them where they need to be & will teach the parent(s) how to teach the child so that they can “become” the therapist
Occupation therapist: OT – works with feeding difficulties, sensory, & smaller muscle groups
Physical therapist: PT – works with larger muscle groups
Speech therapist: works with feeding & speaking
After the intake appointment, the service coordinator goes back to her team to discuss the child and the needs, and they choose which specialty would be the best fit.
The intake appointment also goes over all of the parent’s rights. These are federal rights, the same in every state. They include the right to an evaluation, the right to records (EI keeps records up until the child is 9 years old), the right to privacy (HIPPA), the right to contact the state to make formal complaints, and the right to wait. The right to wait is a little confusing, but it gives the family 10 days to decide if they want treatment to start or not. By signing the right to wait, the parent is giving permission to have a therapy session as soon as possible, whereas not signing the right to wait gives the family time to think about if this is the right choice for them or not. For us, we understand we have the right to wait, but we don’t want to wait 10 or more days for anything to start. We are happy with what’s in place and we give permission to begin services.
System of Payment:
Our service coordinator also explained to us the EI system of payment and how Help Me Grow is considered a “free” program. Help Me Grow is paid for by tax dollars; the service coordinator is employed through the educational service center and the service providers are employed through the board of DD. The service coordinator cannot bill for his/her services, but the service providers do. So with that, even though it is said to be “free”, the “free” hours are not unlimited. The service providers can bill up to 55 hours per year for “free” (paid by tax dollars), but then once those hours are used up, insurance does have to be billed. HOWEVER, our service coordinator did tell us that no family has ever gotten a bill. HMG will not let that happen, they will find a way to make it work if a child needs more than the allotted 55 hours per year, regardless of the family’s insurance.
Your child’s story:
After going over all of the information and paperwork (which we signed electronically right on the spot since our intake was virtual), we finally got into the story of Izzy. 😊 This is when you share the background and history of your child and the concerns you have. As stated above, the service coordinator makes note of everything and the next step is for them to take it all back to their team to see which therapist or specialist would be the best fit.
Sidenote: Because HMG and EI are completely family-centered, the parents/caregivers ultimately make the rules. For one, if we were not happy with the choice of specialist or therapist, they would re-assign. Also, depending on the child’s diagnosis or disability, it is the parent’s choice on where and how to have sessions. With Izzy’s T cell deficiency, we decided that masks are required for anyone entering our home, but we do prefer to have in-person therapy instead of virtual. We just ask for a reschedule or virtual visit if the therapist has been around any type of illness. And again, this would all be your call and what you feel comfortable with. They have been extremely kind, understanding, and agreeable.
Intake was February 1st, I got a call on February 7th after our coordinator met with her team, and our assessment was scheduled for two days later on February 9th.
When I received the phone call to schedule the assessment, our service coordinator shared with me that Izzy was matched with one of their developmental specialists. Both of them would be a part of the assessment. The assessment would also be virtual due to Covid, but then moving forward, treatment sessions would be done in-person, per our request.
So now we have service coordinator and newly assigned service provider (developmental specialist). The start of the assessment was explaining the tools each of them would use to evaluate.
Service coordinators use the RBI tool (Routines-Based Interview). This is a semi-structured clinical interview & needs assessment designed to help families decide on outcomes & goals for their individualized plans.
Developmental specialists use HELP (Hawaii Early Learning Profile). This is a curriculum-based tool & family-centered assessment designed to help families choose developmentally appropriate goals & interventions that relate to the needs of their child & their everyday activities. It focuses on the family’s primary concerns, priorities, and resources.
For Izzy’s assessment, we discussed her play routines, her feeding concerns, her sleep schedule, her interactions with other people, the noises she makes, and her physical movements. We then rated the priority of each of those in regards to what we want to work on the most. Since we already have a speech therapist involved, our top priorities with EI will be play and physical movement.
After they assessed Izzy and shared their thoughts, we scheduled our final virtual appointment – the IFSP.
On February 24th, Sterling and I met with both our service coordinator and service provider again to create our IFSP.
An IFSP is an individualized family service plan. It is similar to an IEP (if you are familiar with that), but for babies. It can be viewed as a “roadmap” to plan out services through the child’s 3rd birthday. It is reviewed every 6 months, but can also be reviewed at any time per the parent’s request.
The IFSP has multiple sections.
Section 1 is Child and Family Information – names, birthdays, demographics, phone, address, etc.
Section 2 is Service Coordinator Information
Section 3 is Eligibility and Assessment
Eligibility includes initial eligibility and annual eligibility for when the time comes to review. One option is a diagnosis, which for us, Izzy’s diagnosis is automatic eligibility and is noted as a “physical or mental condition with a high likelihood of resulting in a developmental delay”. The other option is a developmental delay determined by evaluation.
Assessment includes (1) an evaluation summary of the child’s current development and level of functioning, (2) a family-directed assessment summary which goes over the family’s resources, routines, concerns, & priorities, and then (3) an overall assessment summary that details the child’s strengths, needs, & outcome statements – all in relation to peers the same age.
Section 4 is Child and Family Outcomes – a list of the identified goal(s) & strategies. Each outcome will be reviewed every 6 months (or sooner) to see the progress. This section also breaks down the service information including location, how often, session length, funding source, start and end dates, etc. For now, Izzy will have therapy sessions once every other week.
Section 5 is the final section of the IFSP – Consent. This is where all parties involved sign off.
Each section is completed one by one, and at the end, the service coordinator will provide you with an official copy of the IFSP.
While finishing the family service plan, our provider shared that there will be ongoing care team meetings where the child & their progress will be discussed with the “higher-ups” of Early Intervention, and parents can choose to be a part of these if they wish. EI will also send newsletters out each month and there will be planned play groups and field trips for anyone in the program to join. These are meant to be opportunities for our children to feel safe, to play, to experience new things, and to connect with other families. They also offer respite for clients and/or siblings to have a few fun hours away from home from time to time.
Once the intake, assessment, and IFSP are all completed, therapy sessions can begin. We had our first one 4 days after the IFSP. The initial appointment was a “get to know you” session to make sure Izzy is comfortable with her developmental specialist… and she was! 😊 I can already tell the positive impact this program is going to create for her and for us.