As a pediatric physical therapist, something I hear quite often in new assessments with families is that they "knew something wasn't quite right and had questions on it, but were told to wait and see if it was still a problem" at their next pediatrician visit. Many times, things do work themselves out with development for a variety of factors. Unfortunately, it's not every time. If gaining anything from this article, my advice as a physical therapist and as a parent myself is to trust your instincts. YOU know your child best.
Early intervention has been statistically proven to shorten overall intervention times as well as improve results across all disciplines with children. The challenge with the “wait and see” recommendation is that earlier in your child's medical care at their primary pediatrician, you are seeing each other every four weeks. By the time you may have concerns, your check-in period is every three months. Three months is a long time in a child's first year of development: it's a quarter of their life!
[Related: Preschool, or therapeutic preschool?]
So how does a family pursue occupational, physical, or speech therapy for their child? There are a multitude of different ways to access services, which move along their corresponding timelines for each path. Here are some of your options:
1. Call a reputable, outpatient center or home-based service to provide therapy services.
Turn around time to services: one to two weeks
Look at online reviews, ask for others’ experiences in local parenting groups, access NPN’s referral list — any of these areas could be a good starting point to contact for an assessment for services. Most places will directly call a pediatrician for the prescription to be on file prior to the assessment. In Illinois, you do not need a prescription for physical therapy, as it is a direct-access state. This means that patients can refer themselves and receive ongoing treatment without an initial referral. Reputable outpatient service locations will still gain a referral and share treatment plans and evaluation results
with a primary pediatrician, regardless of the state requirement. You can also ask for this to be done! This is the most direct and fastest way to receive services. This can also be the most costly, especially if you still have to meet an insurance deductible or do not have private insurance to access.
If you are in a rush to prioritize services, an important question during this process is whether the outpatient center or private-based therapy service site providers are also in network with Illinois's Early Intervention system. (We'll review how to access both services down below.)
2. Call the Illinois Early Intervention program.
Turn around time to services: six to 12 weeks, depending on availability
Illinois has a robust Early Intervention program offered for children ages 0 to 3. Services included in Early Intervention are speech therapy, occupational therapy, physical therapy, developmental therapy, developmental vision therapy, developmental hearing therapy, feeding therapy, social work, nutrition services, and diagnostic referral services, to name a few. Services are typically provided in home, in a daycare, or via teletherapy, depending on a family's preference.
[Related: What to look for in a therapeutic preschool]
Families can call the child and family connection facility associated with their home address ZIP code to obtain an assessment and report concerns related to their child's development. Pediatricians or other physicians related to your child's care can also directly refer to the Early Intervention system. To begin Early Intervention services, your pediatrician must agree with and sign off on all recommended services after the assessment. After calling to schedule an assessment, it typically takes two weeks to receive a scheduled assessment. Following the evaluation, recommendations are made and new providers are searched for to provide the recommended frequency of services.
This process in finding your child's provider team can at times be lengthy to get set up, depending on availability of clinicians in your area. Despite the issues with timely services, the benefits to using the Early Intervention system are great for families! Monthly family fees are assessed based on number of family members and overall household income. This family fee is set from $0 to $200 max per month. Early Intervention can act as your primary insurance (as in, the only insurance plan that is billed for therapy services), or it can act as your secondary insurance (e.g., the insurance to handle any unpaid amounts after visits are processed by your primary insurance plan). Because of this set up, Early Intervention can provide an extremely affordable and accessible means for therapy services for children up to the age of three.
3. Combination of utilizing private insurance and the Early Intervention system through the state of Illinois.
Turn around time: one to two weeks to get started; up to three months to bring on Early Intervention coverage
At times, when a problem has been identified, waiting several months for services can feel like a lifetime. This is where a provider that can initially work with your insurance plan, that has providers certified through the Early Intervention program, can work nicely. Think of it as billing just your primary insurance for the first weeks before Early Intervention can "kick in." Early Intervention can then be used primarily as your benefits plan or to help supplement your insurance plan. Finding an initial provider that provides both services is also helpful so that you do not have to get services started and then switch providers to a different facility.
Hopefully this has been a useful guide to accessing services and pursuing early intervention for your child. Again, listen to your instincts, pursue help when needed, and don’t rely on “wait and see”: it could prove to take even more time to make gains with this approach.