Changing Dynamics for Early Intervention Services

February 13, 2018

In 2009, Grafton partnered with the City of Winchester to provide children in six different localities — Frederick, Clarke, Warren, Page and Shenandoah County as well as the City of Winchester – with early intervention services. Prior to Grafton’s involvement, despite a population of 220,000, only 92 children were in the program; today, the number of those enrolled exceeds 300 with many more in the process of coming onboard.

The program, known as the Infant and Toddler Connection of Shenandoah Valley (ITC-SV), offers services for children ages birth to three who are not developing as expected due to either a medical or cognitive condition. Through the program, a parent-coaching model is used to help families reinforce strategies and develop skills to assess developmental delays, gains and milestones. The ITC-SV’s team of licensed and certified professionals works with parents and caregivers to understand their baby’s cues and possible developmental problems.

Over time, the nature of the referral behaviors has certainly changed. One of the largest factors at the moment is a public emergency resulting from Virginia’s opioid addiction crisis: emergency room visits due to drug overdoses increased 89% from 2015 to 2016. In addition, more people died in 2014 from opioid overdoses than from fatal car accidents.

The Impact on Infants and Young Children

Sadly, this crisis is affecting the state’s youngest and most vulnerable population in a variety of ways. It is estimated that the rate of babies born with Neonatal Abstinence Syndrome (NAS) — a treatable condition that newborns experience while in utero after chronic exposure to certain substances, primarily opioids — nearly tripled from 2000 to 2009. This has myriad implications: the average length of hospital stay for a baby born with NAS is 23 days compared to one to two for a healthy newborn. In addition, costs associated with babies with NAS are estimated at $53,400 per birth compared to $9,500 for other births. In the state of Virginia, infants who are diagnosed with NAS are automatically eligible for Early Intervention services under Part C of the Individuals with Disabilities Act (IDEA). Prenatal substance exposed infants now comprise approximately 30% of referrals to the ITC-SV. Another 25% of those referred are infants with a NAS diagnosis.

But delays and atypical development are not always apparent immediately after birth; many are identified at 12 months and beyond. And, certainly, the correlation between substance exposure and environment is still being debated. Regardless, in cases of in-utero substance exposure, it is critical to pay attention to subtle cues such as the baby’s attachment to the caregiver, a cornerstone for healthy social emotional development and an indicator for future success in school. Too often, the social and emotional development of babies is over looked as parents and physicians are focused on more observable signs of developmental delays, such as late walking or talking.

Parents & Caregivers Struggle, Too

Parents and caregivers struggling with substance abuse are facing challenges of their own while also trying to care for a baby with complicated needs. Often, the mother or caregiver is reluctant to accept services for fear of being judged. Other times, the subtle challenges a NAS baby has, compared to typical babies, goes unrecognized. Families need to know that the role of early intervention is to help them develop the skills and knowledge to address the needs of their baby. It is not to separate them from their child.

ITC-SV’s team has a track record of working with families with substance abuse issues and children with developmental concerns. To address the unique challenges these families face, the team may even meet with them while their baby is still in the NICU, offering information and guidance while setting the groundwork for a trusting relationship.

Help is Available

Grafton’s early intervention providers are able to offer a range of supports and services, depending on the concerns the family may have. Ongoing service coordination is offered to provide monthly monitoring and guidance on typical child development. Other professional services — such as physical, occupational, and speech therapy — may be provided to address feeding or sensory issues, atypical social development or motor and language delays. Education and guidance on attachment are also an area of focus, helping to promote healthy social emotional development.

The ITC-SV team is working hard to address the growing crisis in Virginia and the changing needs of the population we serve. Investing in our state’s youngest population is an investment in a brighter future for us all.