This pilot research project will investigate the delivery of early intervention services in rural Montana and identify professionals’ strengths and areas for improvement, as well as possible barriers to providing services aligned with research-based recommended practices. These quantitative and qualitative data will be used to meet the project’s immediate goal of providing feedback to professionals in Montana about the delivery of early intervention services, as well as to identify ways to support these professionals to provide family-centered early intervention. These data will also be used for this project’s future goal, as part of a major research project: to carry out Community Based Participatory Research to create family-centered professional development specifically designed for the challenges faced by early intervention professionals, particularly those who serve the most rural children and families; this professional development would then be provided using a randomized control trial in rural areas of Montana to determine its effectiveness. This current pilot investigation of early intervention service delivery and identification of barriers to providing family-centered services is the first step toward the long-term goal of supporting the health and well-being of some of the most vulnerable individuals in Montana – infants and toddlers with delays and disabilities living in rural areas.

Montana is listed 50th in the nation for children’s health (Annie E. Casey Foundation, 2014). For infants and toddlers with delays and disabilities, who are in the most vulnerable period of their development and are at risk to experience lifelong health challenges, family involvement is a critical determinant for the impact of early intervention services on their well-being and developmental outcomes. Therefore, there is a need for supporting Montana’s children in the context of their families. Family-centered services are crucial given the limited amount of time that early intervention professionals spend with children on a monthly basis in comparison to the exorbitant amount of time these children spend with their families; consequently, children’s health and development can be influenced to a much greater extent if parental involvement is a targeted priority for early intervention services. Based on families’ reports of the way in which early intervention services are being delivered in Montana, there is reason to believe that early intervention professionals are not providing services that are in line with research-based recommendations, especially in the most rural areas of the state.

Specific Aims

Aim 1: Investigate the ways in which services are delivered by early intervention therapists, and how this aligns with family-centered practices. This will be completed via videotaped observations of physical, occupational, and speech therapists as they provide early intervention services to a child; each professional will videotape themselves providing early intervention services with at least 3 different children. These videos will be rated using the Home Visit Rating Scales A+ – Adapted and Expanded (HOVRS-A+), a well-established scale used to measure the alignment of early intervention services with family-centered recommended practices (Roggman, Cook, Innocenti, Jump Norman, Boyce, & Christiansen, in press). I hypothesize that early intervention professionals in the state of Montana are providing services to infants and toddlers with delays and disabilities in ways that align much more closely with a medical model than with family-centered recommended practices.

Aim 2: Investigate therapists’ knowledge, attitudes, and experiences regarding family-centered early intervention services, as well as their perceived barriers to providing family-centered services. This will be completed via a semi-structured qualitative interview with each therapist. I do not propose a specific hypothesis for this portion of the study; since this portion of the study is exploratory and qualitative in nature, proposing specific hypotheses could lead to interpreting the data with biases.

Primary Contact

Kalli Decker kalli.decker@montana.edu