Special Needs: Early Intervention Challenging During Pandemic

By Deborah Jeanne Sergeant

When schools faced mandatory shutdowns last spring during the pandemic, education has shifted to virtual modes.

For pre-kindergarten children needing early intervention for their special needs, meeting through Zoom or Facetime isn’t always effective. Many parents delayed seeking the intervention.

Cindy Toleman, director and CEO of Clinical Associates of the Finger Lakes in Buffalo, serves families needing special education services for speech, language, occupational therapy, physical therapy and autism. Though she’s glad the state moved swiftly to approve teletherapy models, “it’s so difficult,” she said. “Not every family is prepared or has the ability to use that kind of service. It can’t be just phone calls but must include a video component.”

Some families lack high speed internet access. Others must juggle all their newfound computing needs among several family members, such as parents working at home and trying to educate older children at home.

Toleman said to compensate for this the virtual therapy, her therapists have offered more activities for parents to do at home with their children as well as interacting with children on the screen.        

“Our staff was great,” she said. “I’m a bit in awe with how quickly they adapted to this new service delivery model. Most of the struggle has been because most of the therapists are parents themselves and their children are at home trying to home school. Scheduling is always an art.”

Since they’re also working around their own families’ needs, the therapists haven’t been seeing as many children, but the smaller caseload also means less income for the therapists.

“We all thought it would be a quick one or two-month thing,” Toleman said. “Now that the pandemic seems to be better under control, the state is opening to in-person visits. But a lot of children have not received the services to which they’re entitled.”

She thinks that once therapists can evaluate a child’s status, they may find they need to begin “more intensive levels of therapy to make up for that lost time,” she said. But she’s not sure how long these effects will last.

While engaging with children first hand is ideal, Toleman has seen more parental involvement because of both the unavailability of therapists to treat in person and also because parents’ schedules have otherwise cleared.

Lori Prelewicz, children’s services supervisor at People, Inc. in Buffalo, said that at her organization some families have not participated in teletherapy because the parents are working at home and trying to educate their older children. They may not have sufficient access to devices to accomplish all these tasks or they may lack reliable internet access.

“Some have been successful with teletherapy and some have not,” Prelewicz said. “Some have just had enough of it. The kids sometimes will engage. A lot of it is parent coaching. It has not been an ideal method for implementing services.”

She added that some families don’t have the right supplies or equipment at home, although the therapists try to include objects most families would have available, such as couch cushions as aids in physical therapy.

“One therapist said she has a difficult time and shows the child a toy and what she wants the child to do with it but the child can’t touch it,” Prelewicz said. “For some families it works very well. But even with those families it does work very well with, for how long it’s not as clear.”

She thinks that the lack of early intervention will affect children long-term, since children develop many essential skills between birth and age three.

“I believe it will affect them for quite some time and it will take a while to catch up,” Prelewicz said. “Some of these kids, if they’re speech only, they need early intervention to catch them up but if they continue to not receive services they’ll need it possibly while they’re ready to go to school.”

In addition to hampering the children’s short-term and possibly long-term development, delaying therapy costs more. It has been estimated that $7 to $12 is saved per $1 spent on early intervention done by age 3. Waiting costs the education system more money. In addition, early intervention sets up children who need it to be better learners.

Like many others, the organization is beginning hybrid sessions— some in-person and some remote — but the regulations allow services to be delivered in a site with safeguards in places. Normally, they would meet with a family in the child’s home. Only a few exceptions to the rule are allowed. While the weather holds, therapists are meeting outdoors with families.

“We’re hoping things will open up more,” Prelewicz said. “Our state has been opening up pretty well and our rates remain low so I’m hoping these children can receive the therapy they need as soon as possible.”