Why Natural Environment Services are Best for Ages 0-3

Part C of the Individuals with Disabilities Act requires services provided by Early Childhood Intervention programs (ECI) occur in the child’s natural environment. This means that providers come to the child wherever they typically spend their time, whether it is at home, in day care, or in Early Head Start. ECI services are designed to help that child function within typical routines of the day and the environment. This is best accomplished by the provider blending into the day care classroom or at the breakfast table at home, demonstrating strategies for the parent/caregiver to help the infant/toddler adapt to typical routines and settings.

The parent/caregiver is the single most influential person in the life of an infant/toddler, so providers want them to be very hands on during sessions. The therapists demonstrate the technique to the parent/caregiver, and then they demonstrate mastery by trying it out. For instance, for an infant with slight muscle tone issues, a motor therapist might demonstrate leg exercises to do with the infant while he is lying on his back. The therapist explains that because the infant has several diaper changes per day, simply doing the exercises for a short period of time at each diaper change will help the infant. It is unrealistic for the therapist to come and perform the exercises at each diaper change for the child, but it is realistic and highly beneficial for the parent/caregiver to apply the strategies taught throughout the day and until the next visit.

Sometimes toddlers will do things at day care that they do not do at home. Biting is one example. It is important to find out why the child is biting-but it is typically to fulfill a need or cope with something[3]. We’ll talk more about this in another article, but until then, a toddler may be biting at day care and not at home. In that instance, it is important for the ECI provider to visit the classroom, talk to the day care caregiver, and try to identify why the toddler is biting. Then, the ECI provider can help the parent/caregiver identify ways to stop the biting at the day care that can be successfully implemented by the day care teachers. It’s a win for everyone.

Older siblings can also be very good teachers to their little brother or sister. Just the other day, a seven-year old brother to his two-year old sister was able to tell the evaluators a complete list of all of the words she had, the foods she liked best, what food textures she hated, and why she pulled his hair a lot when they were playing. He was an excellent historian for her, and had she qualified, he would have been instrumental in helping her practice therapeutic strategies. While she didn’t qualify, we were able to give mom and brother some strategies to use to help her use more sentences.

The whole goal of service in the natural environment is inclusion. The ultimate goal for every ECI child is to be able to participate in the same activities and routines as typically developing children. Adaptations may be needed, such as a wheelchair or heavy sensory work before an activity, but ECI aims to help the ECI child fully participate to the extent possible and get the most out of interactions. It is very sad to ECI providers when they see a developmentally or physically disabled child being excluded from a game or activity. They want to participate, and with some modifications, they typically can. Playgrounds can be a bit tricky to navigate for a child of any age when physical disabilities are involved. Bay Area Rehabilitation Center has a playground specifically designed to accommodate every child, and it is open to the community all the time. A playground can be a highly enjoyable part of a child’s natural environment, so ECI therapy sessions are often held on our playground when the weather is nice.

Whether you see ECI providers on the splash pad at the local water park, in the day care classroom, in the home, or scaling the playground out in front of Bay Area Rehabilitation Center, know that they are passionate about helping all young children participate fully in life and childhood!

Chasey Reed-Boston has served as Program Director for Bay Area Rehabilitation’s ECI program for the past six years. She earned her Bachelor and Master degrees from Liberty University in Lynchburg, Virginia and is currently completing her doctoral dissertation focusing on productivity requirements in Texas healthcare settings and their impact on service quality. Chasey is married with two adult children, a host of “adopted” young adults, and an aging and opinionated German Shepherd named Oscar.

  1. Early Childhood Intervention. 34 CFR Part 303. Code of Federal Register: Washington DC.
  2. DiLauro, E. (2012). Reaching families where they live: Supporting parents and child development through home visiting. Zero to Three.
  3. Zero to Three Resource. (2016). Toddlers and biting: Finding the right response. Zero to Three.