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Early Intervention Speech Therapy

Interview with Helen Vadala, MS, OTL: Pt. 3

Published July 12, 2011 9:00 AM by Stephanie Bruno-Dowling
Today is the final part of my interview with Helen Vadala, MS, OTL. Our discussion continues as we explore the changes affecting the preschool portion of early intervention.(You can read the first part here, and the second part here.)

Steph: What changes have you seen in the 3-5 preschool early intervention system in the last few years?

Helen: Just like infant-toddler services have changed over the 20+ years that I have been in this field, so have the services in the 3- to 5-year-old preschool system. When I first started as an occupational therapist in early intervention, preschool children received full time, five-day programming. Now children generally receive half-day programming, and it can vary anywhere from two to five half days. Very few children receive full-time programming now through special education approved private school (APS) funding.

In the last two years, preschool services have followed suit with infant-toddler services in that the push is to provide children special education in the natural environment. This is supported through the law in that children are entitled to receive services in the least restrictive environment. This more literal interpretation of the law is drastically changing the face of both special education and early childhood education. These services, along with infant-toddler, have been unified under the Office of Child Development and Early Learning (OCDEL), a new division in Pennsylvania state government that was created approximately 4-5 years ago. Fewer children are being serviced in special education classrooms and more in community programs. As community programs are expected to support children with special needs, more training and program supports need to be in place. Church nursery schools and private preschools and childcares are not well-equipped to deal with the accommodation needed for children with special needs. Thus the push is on for "highly qualified" teachers, and monies are being made available to support the increased educational requirements for teachers in the preschool system. Keystone STARS, a state certification program for preschools and childcare centers, has also aided in improving the quality of typical programs.

The development of PA standards for preschool (developmentally appropriate skills that should be taught and given focused), much like school-age standards, has also assisted in the development of higher quality preschools and childcare centers. The use of well-known curricula that support the PA learning standards has further enhanced typical centers in providing quality education to our preschool children in general.

Steph: So what does all this mean for our special education students? 

Helen: It lays a better groundwork so that accommodations and special services can be infused into the typical programs. However, it is a work in progress and many centers are not able to meet the state criteria to attain the supports offered. Certification under Keystone STARS is arduous and time consuming.  Many "mom and pop" preschools and smaller childcare centers just don't have the resources to support participation in the state initiative.

Another issue with the push for highly qualified early childhood education is that teacher and childcare worker salaries are poor, thus not supporting the level of education that the personnel need to be considered "highly qualified." The state is aware of these issues and is working through state-funded programs like Headstart and Pre-K counts to provide the quality early childhood education that benefits both typical children and allows integration of special needs children with more success. However, participation in these programs is limited by low income requirements and limited availability. Basically, there just aren't enough of them due to funding. And funding is shrinking, not growing, in the current fiscal environment. As I said, it is a work in progress. The early childhood community is working hard to improve services for all children, and the state of PA is being closely watched by the rest of the country as we push this early education model. 

Steph: So what does all this mean for special education programs? 

Helen: It means that children being serviced in these types of programs are the more needy population. They are children who require a higher degree of individualized supports and accommodations.

Based on my limited experiences, it appears that the children being serviced in these programs are more cognitively and behaviorally challenged. Ironically, however, as the population became more needy, the state ratios of students to adults went up. Previously, there was a 3:1 ratio (3 children to every one adult) in what is termed "developmental delay classrooms." Now it is 11:2 (11 children to two adults). This has most definitely created some daily operational challenges. As children who need more individualized supports are placed in these classrooms, higher student-to-teacher ratios makes this individualized programming challenging. This is especially true given the increase in behaviorally-challenged children serviced through special education. Integrated therapies (the provision of OT, PT and ST in the classroom versus pull-out) aids in the management of the students in these settings. Integrated therapy also has added benefits in that the children learn the skills where they need to learn them and that the teachers learn the special strategies offered by each of these disciplines, so follow through in the classroom is more likely. Also, the recent provision of Positive Behavior Support (PBS) training through the American Recovery and Reinvestment Act (ARRA) funds and a PA state grant has assisted in the management of behavior for all children.

I have experienced this directly as an internal coach for the PBS grant and have found the benefits in the classroom to be great. I would encourage anyone working in this setting to learn more about PBS and its use in early childhood education. 

Change is always hard in any system, but systems that are stagnating die. So it is actually a good thing that early childhood special education is able to morph and change to meet the needs of a changing population and fiscal environment. As the typical preschools and childcare centers improve through the use of PA standards, highly qualified teachers, the use of positive behavior supports and the use of a standard curriculum, the infusion of children with special needs will become easier.

There will always be a need for special programs to service the children who need a higher level of individualized support than can be offered in a typical setting. These programs need to also keep up with the changing demands and be ready to accommodate behavioral challenges and increased cognitive delays we're seeing. I think it's pretty cool that OCDEL has unified all children's services and is looking to the future to be better able to service children along a continuum of care. I hope PA continues to be a front runner in this area of practice and feel privileged to be able to participate in it. As I have said in my other blog interviews, can you tell I love what I do? Thanks for allowing me the opportunity to tell you my perspective on this great job I have. Now, Steph, its back to work we go!

Steph: Why, yes it is! You are welcome, Helen. Thank you for sharing your insights and expertise! Remember if anyone is interested in contacting Helen, especially if you are looking to work in homecare in Delaware County, she can be reached at 610-308-7198 (cell), or



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About this Blog

    Stephanie Bruno Dowling, M.S. CCC-SLP
    Occupation: Speech-Language Pathologist
    Setting: Early Intervention in Delaware County, PA
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