Early Intervention - Making it work for you

Many families of premature babies are offered early intervention (EI) services. While these services can be helpful and useful, it can also be frustrating. Here are some tips to make your early intervention program work for you.


1. Early intervention vs. doctors. Unlike doctors (who are normally there to do procedures, tell you when/how to treat something, etc), early intervention services should give you ideas and suggestions for things you can do at home with your preemie. EI is there to help you help your preemie. Giving you physical, developmental and emotion ideas and support to ensure your preemie continues to develop appropriately. This is a key difference and keeping it in mind will help you determine if the services you receive are what you want/need.

2. Establish goals. Your EI team should create goals for your preemie (with your help). Normally they are 6 month goals however there is nothing wrong with creating shorter term goals as well. These goals are a great way to determine if things are working and if progress is being made. Your preemie may not always meet the goals in the time frame specified, but it is a good way to know if things are on track. Make sure you put your input into the goals. You know your preemie the best so you can help establish realistic goals. If you aren't happy with a goal or think that one is unnecessary - speak up! For example, my son was a horrible sleeper as a child. He wouldn't go down on his own and we didn't opt to do the "cry it out" technique. Every 6 months our developmental therapist would put down "go to sleep on his own" or some variation and every 6 months he wouldn't meet it. I had to explain that this was not an area where I needed their assistance so we finally were able to let it go. On the flip side, if you think something should be on there that is not - ask to have it included.

3. Personality fit. It's important that you and the specialists are a good fit personality wise. This doesn't mean that they need to be friend material - just that you can handle seeing them frequently and you appreciate their approach to things. I had one specialist who really got on my nerves - it made it hard to really focus what she was talking about because I just sat there annoyed. That isn't helpful for anyone. If you don't like someone (to the point that you can't work with them) or you don't like how a specialist works with your child and/or their approach to early intervention than ask for someone else. This is especially important if you are seeing this person frequently and they are working closely with you and your preemie.

4. Ask questions. The early intervention specialists should be showing you how to do things with your preemie at home/when they aren't there. Make sure you understand what they are saying or showing you. Also find out why they are suggesting something - what is the goal of the movement, activity or game. The more you understand, the better you will be able to work on it yourself (or come up with a personalized way to do it).

5. Ask for more or less. Some preemies end up "catching up" up faster than others so you may want to scale back the number of times you see the developmental therapist. Other preemies need more services. Let your coordinator know what you require so that changes can be made. The more you take control of these services - the more you can ensure that you are getting what you need (and not more or less).

6. At home vs. School setting - Depending on your preemie's health/situation and/or regional offerings, you may receive early intervention services at home or in a school setting. Both options have their pros and cons. I encourage you to try out what is offered and then decide if it is something you want to continue doing.

Working therapy into every day

I don't know about you but as the parent of two preemies, I have always felt this enormous pressure to constantly be working with my kids on various developmental skills. Both of my kids have been or were in physical and developmental therapy for several years. The amount of things to work on can seem long and never ending. Trying to fit therapy time/skill building into your day can seem impossible but it can be done. Here are some tips to get therapy time into every day.

1) Play time is therapy time - Preemies spend a lot of time playing. Play time is the absolute perfect time to work on various developmental and physical skills. I normally try and work on one particular skill at a time. My daughter is currently working on trying to crawl so as soon as she is on her tummy I pull her into a crawl position and let her work on that for a few minutes before she starts playing with her toys independently. If you are working on teaching your preemie how to "share" objects than sit in front of him/her and start giving him/her toys and then asking for them back. Trying out one skill at a time throughout the day can go a long way towards helping your preemie develop and help you keep your sanity.

2) It's all in the set-up - If your preemie is working on a specific skill, set-up his/her toys to help facilitate that. For example, if your preemie is learning how to look from one side or the other - place his/her toys so that he/she has to look one way to see them. Put toys farther away if you want your preemie to try and reach for toys or move towards them.

3) Set a timer - We all get busy with the demands of life so it can be hard to remember to actively work with our preemie on something. If you need a small reminder than set a timer. When it goes off that is your cue to work with your preemie on something specific.

4) Short periods of time - You don't need to constantly work with your preemie on various skills. Most preemies do better if they only have short amounts of time where they are actively having to work on something. It also helps them remember a skill if they work on it several times in a day rather than a long period of time once a day. Work with your preemie a little and then let him/her play independently.

5) Sibling help - Older siblings can be a great help for teaching your preemie new skills and working with them on certain things. My son is four and a half and he is my daughter's favorite form of entertainment. I have often asked my son to come over and play a game with my daughter so that she stays interested and continues working on a particular skill. He loves to see her try new things as much as I do so he is also a great cheerleader for her.