**Early Intervention (EI)** is about making sure children with additional health or learning needs have the necessary support to grow and thrive in the early years from 0-5.

There are two main providers of EI in New Zealand:
- The Child Development Service (CDS), a non-medical service of Te Whatu Ora, Health New Zealand. 
-  Early Intervention Services (EIS) at Learning Support, Ministry of Education.

The first of these, the Child Development Service, is delivered through your local Te Whatu Ora provider, which until July 2022, was your local District Health Board. 

### So how do I access CDS?
Normally your GP, Plunket Nurse, or paediatrician will refer you to your local CDS. 

CDS provides ongoing services to meet the health needs of children with developmental delays or a disability.  They operate on specific entry criteria provided by the Ministry of Health, so someone from CDS will contact you on referral, to see if your child qualifies. This is also an opportunity for you to discuss what goals you have for your child and to discuss any difficulties your child may be experiencing. 

Unlike the Ministry of Education’s EIS, which is for children from the age of 0-5, CDS support is available until your child is 16.  Both services are government funded and free of charge. 

As with the old DHB system, service delivery can vary in structure and format, according to which part of the country you live in, but it is likely a **Child Development Team will** form around your child, who will coordinate assessments and support. Where possible, support will be delivered in your home, allowing you to take an active role in your child’s care. 

### Who is in the Child Development Team?
Depending on the nature of your child’s delay or disability, you may have contact with several different professionals, or potentially only one. Most visits are likely to take place in your home where health professionals can assess your child in their everyday activities and offer ideas on how to support their development. 

These professionals may include:
**Physiotherapists,** who assess your child’s play and movements and how this impacts on their development. 
**Occupational therapists**, who provide strategies to help your child with everyday activities. They may assess your child’s sensory, motor and perceptual skills.
**Speech Language Therapists/Dieticians,** who can address feeding and swallowing concerns in babies and young children. They will offer give guidance on how to make sure your child is eating safely. They may also offer support for problem eating.
**Clinical Psychologists,** who will assess your child’s learning, social and cognitive skills. They may also wish to meet with your child’s teachers or kaiako at their Early Childhood Education Centre or Kohanga Reo. 
**Social Workers**, who will help you access the resources and services you need. 
**ASD Coordinator** who helps families identify developmental goals for autistic children
**CDS Coordinator** who manages referrals and coordinates the members of the Development Team to ensure you are getting the help you need. 

### Things for parents to remember:
- Even if you feel some relief that concerns about your child’s development are now being addressed, it is natural to also feel stress and anxiety at the beginning of assessments and services. But remember, **you are taking positive action for your child’s development.**
- **As the expert on your child, you should always be consulted about all aspects of their treatment. **
- Children progress best when there is a mutually respectful and collaborative relationship between their parents and EI professionals. 
-  Be prepared for the process to take some time and take it one day at a time. What is an issue now may not be an issue next month or next year. Celebrate each achievement.
- R**emember your child is a child first and foremost**. Build in time for them to play, explore and simply enjoy your company, and that of the rest of your family.
- **It is easy to get overwhelmed** by repeated visits to or from health professionals. Space them out if possible, to allow you and your child to recharge between appointments.
- **Take a support person with you for important visits. **Tell them about any issues you wish to raise beforehand, so they can remind you during the appointment if you need it. 
- If you are unclear in any way about what a health professional is saying to you – be it medical jargon or complicated processes – ask for clarification.
- Keep all your child’s relevant medical information in an easily accessible folder, or electronic device. 

For more on Early Intervention, check out other articles in this series on Awhi Nga Matua. You might also find the resources below useful, which include website, books and articles from the IHC Library. Or contact the IHC library direct to have a chat about what you need on 0800 442 442 or email: [Librarian@ihc.org.nz](mailto:Librarian@ihc.org.nz).

**Videos:**
·      What is Early Intervention? (<https://www.youtube.com/watch?v=1TdNbOco9jU>)
·       The Power of Early Intervention: What happens early matters for a lifetime (<https://www.youtube.com/watch?v=doZAS-tHBm4>)

**Helpful websites:**
·      Early Intervention Services - [www.education.govt.nz/early-childhood/teaching-and-learning/early-intervention/](http://www.education.govt.nz/early-childhood/teaching-and-learning/early-intervention/) )
·      Plunket Whanau Awhina - [www.plunket.org.nz](http://www.plunket.org.nz/) 

·      Children’s Health, Starship, Te Whatu Ora /Te Toka Tumai Auckland -[www.adhb.health.nz/our-services/a-z-services/childrens-health/](http://www.adhb.health.nz/our-services/a-z-services/childrens-health/)
·      Child Development Centre, Te Whatu Ora/ Waikato - [www.waikatodhb.health.nz/about-us/a-z-of-services/child-development-centre/](http://www.waikatodhb.health.nz/about-us/a-z-of-services/child-development-centre/)
·      Child Health, Te Whatu Ora Health New Zealand/Lakes - [www.healthpoint.co.nz/public/paediatrics/child-health-lakes-te-whatu-ora/child-development-team/](http://www.healthpoint.co.nz/public/paediatrics/child-health-lakes-te-whatu-ora/child-development-team/)
·      Child Development Service, Te Whatu Ora Health New Zealand/Southern - [www.southernhealth.nz/services/child-development-service-southland-southern-te-whatu-ora](http://www.southernhealth.nz/services/child-development-service-southland-southern-te-whatu-ora))
·      Child Development Service, Te Whatu Ora Health New Zealand/Waitaha Canterbury - [www.cdhb.health.nz/health-services/child-development-service/](http://www.cdhb.health.nz/health-services/child-development-service/)
·      Community Child Health, Te Whatu Ora/Waitemata - [www.waitematadhb.govt.nz/hospitals-clinics/clinics-services/community-child-health](http://www.waitematadhb.govt.nz/hospitals-clinics/clinics-services/community-child-health)
·      Child Development Service, Wellington Regional Children’s Hospital Te Whatu Ora/Capital, Coast and Hutt Valley - [www.ccdhb.org.nz/our-services/wellington-childrens-hospital/](http://www.ccdhb.org.nz/our-services/wellington-childrens-hospital/)
·      Child Development Service, Te Whatu Ora/Health New Zealand/MidCentral - [www.midcentraldhb.govt.nz/HealthServices/ChildHealth/Pages/Child-Development.aspx](http://www.midcentraldhb.govt.nz/HealthServices/ChildHealth/Pages/Child-Development.aspx)
·      Whaikaha – Ministry of Disabled People - [www.whaikaha.govt.nz/support-and-services/specific-disability-services/child-development-services](http://www.whaikaha.govt.nz/support-and-services/specific-disability-services/child-development-services)
·      Early Intervention Foundation ([www.eif.org.uk](http://www.eif.org.uk/))









Emily Writes

A mother smiles at her daughter as her father sits next to her

Early Intervention - What health services are available to help my child thrive?

health services, early intervention, new zealand, te whatu ora, early help for my disabled child, help for possibly autistic child, possible ADHD, undiagnosed adhd, autism, early therapies

**Early Intervention Services (EIS)** operates under **Learning Support** at the **Ministry of Education**, to help very young children with extra learning needs.
 
It is a free, needs-based service, so if you, or your Well Child provider, have any concerns about your child’s social, or cognitive development it may be worthwhile getting in touch with the EIS. You do not need a diagnosis to access support.

If your child is already at an **Early Childhood Education (ECE) Centre**, you may prefer someone from the centre to contact EIS on your behalf. They can only do so, however, with your full permission.

Someone from EIS will contact you to discuss your concerns and your goals for your child, and importantly, what you would like to happen next. Using the information you provide them with, EIS will form an **Early Intervention team** to work with you and your child. Together you will develop a plan to support your child’s learning and development. 

As EIS provides support to children from birth to the age of five, in the first few years, it is likely that support will be provided in your own home.
After the age of three, your child’s **Early Intervention Plan** will most probably include supporting them at their ECE service or Kohanga Reo.

### Early Intervention Teams can include:
- Speech-language therapists
- Psychologists
- Early Intervention Teacher
- Kaitiakawaenga (Maori Cultural Advisers)
- Education support workers
- Advisers on deaf children.

### **What happens once my child turns five?**
Like all children in New Zealand, once your child turns five, they transition from pre-school to primary school or home-schooling. At this point your child may no longer need extra support to engage fully in school life – either socially or in their learning journey. 

This may not be the case for other children, and for those children especially, it is important to manage the transition carefully, planning well in advance of their start date.

Make sure your pre-school has passed on relevant information about your child’s needs, strengths, interests and goals. Also, do your best to prepare your child for this big change in their daily life. Reassure them that they will be supported every step of the way. 

Talk to the school yourself, preferably to your child’s kaiako and the SENCO teacher about your child’s needs and find out what resources they can access. There are a number of options available depending on your child’s level of need including:

- The Special Education and Operations Grant
- Ongoing Resourcing Scheme
- School High Health Needs Fund
- Severe Behaviour Service
- Communication Service.

For some children mainstream schooling may not be the best option – explore what else is available such as special schools that address your child’s needs in a more targeted way. 

[Visit the Early Intervention Service website](http://www.education.govt.nz/early-childhood/teaching-and-learning/early-intervention) or phone Learning Support on 0800 622 222, for full details.

For more on Early Intervention, check out other panui in this series on Awhi Nga Matua. You might also find the resources below useful, which include website, books and articles from the IHC Library. Or contact the IHC library direct to have a chat about what you need on 0800 442 442 or email: [Librarian@ihc.org.nz](mailto:Librarian@ihc.org.nz).

**Kids’ Books from the IHC Library**
·      _Quinn at School – Relating, Connecting and Responding at School – A book for children ages 3-7_ – Rick Warren

**Books for Adults from the IHC Library**
·      _Early Childhood Intervention without Tears – Improved support for infants with disabilities and their families_ – Peter Limbrick
·      _Early Intervention Every Day! – Embedding Activities in Daily Routines for Young Children and their Families_ – Merle Crawford, Barbara Weber
·      _Cara’s Kit for Toddlers – Creating Adaptations for Routines and Activities_ – Philippa Campbell, Suzanne Milbourne, Alexis Kennedy
·      _Early Intervention Practices Around the World_ – S. Odom, M. Hanson, J. Blackman, S. Kaul
·      _The Early Intervention Guidebook for Families and Professionals – Partnering for Success_ - Bonnie Keilty
·      _Group Play Interventions for Children – Strategies for Teaching Prosocial Skills_ – Linda Reddy
·      _Early Learning Goals for Children with Special Needs – Learning Through Play _- Collette Drifte
·      _Small Steps Forward – Using Games and Activities to Help Your Pre-school Child with Special Needs – _Sarah Newman
·      _DEC Recommended Practices – A Comprehensive Guide for Practical Application in Early Intervention/Early Childhood Special Education_ – Susan Sandall, Mary Hemmeter, Barbara Smith, Mary _McLean_
·      _Teaching Individuals with Developmental Delays – Basic Intervention Techniques_ – I. Lovaas 
·      _Working with Families of Young Children with Special Needs_ – R. A. McWilliam
·      _Inclusion in the Childhood Classroom – What makes a difference_? – Susan Recchia, Yoon-Joo Lee
·      _Prevent, Teach, Reinforce for Young Children – The Early Childhood Model of Individualized Positive Behaviour Support_ – Glen Dunlap, Kelly Wilson, Phillip Straing, Janice Lee
·      _Helping Children to Improve their Gross Motor Skills – The Stepping Stone Curriculum_ – Rachel White
·      _Cerebral Palsy in Infancy Targeted Activity to Optimize Early Growth and Development_ – Roberta Shepherd
·      _Young Exceptional Children – Family-based practices –_ E. Horn, M. Ostrosky, H. Jones

**Videos:**
·      What is Early Intervention? (<https://www.youtube.com/watch?v=1TdNbOco9jU>)
·       The Power of Early Intervention: What happens early matters for a lifetime (<https://www.youtube.com/watch?v=doZAS-tHBm4>)

**Helpful websites:**
·      Early Intervention Services - [www.education.govt.nz/early-childhood/teaching-and-learning/early-intervention/](http://www.education.govt.nz/early-childhood/teaching-and-learning/early-intervention/) )
·      Plunket Whanau Awhina - [www.plunket.org.nz](http://www.plunket.org.nz/) 

·      Children’s Health, Starship, Te Whatu Ora /Te Toka Tumai Auckland -[www.adhb.health.nz/our-services/a-z-services/childrens-health/](http://www.adhb.health.nz/our-services/a-z-services/childrens-health/)
·      Child Development Centre, Te Whatu Ora/ Waikato - [www.waikatodhb.health.nz/about-us/a-z-of-services/child-development-centre/](http://www.waikatodhb.health.nz/about-us/a-z-of-services/child-development-centre/)
·      Child Health, Te Whatu Ora Health New Zealand/Lakes - [www.healthpoint.co.nz/public/paediatrics/child-health-lakes-te-whatu-ora/child-development-team/](http://www.healthpoint.co.nz/public/paediatrics/child-health-lakes-te-whatu-ora/child-development-team/)
·      Child Development Service, Te Whatu Ora Health New Zealand/Southern - [www.southernhealth.nz/services/child-development-service-southland-southern-te-whatu-ora](http://www.southernhealth.nz/services/child-development-service-southland-southern-te-whatu-ora))
·      Child Development Service, Te Whatu Ora Health New Zealand/Waitaha Canterbury - [www.cdhb.health.nz/health-services/child-development-service/](http://www.cdhb.health.nz/health-services/child-development-service/)
·      Community Child Health, Te Whatu Ora/Waitemata - [www.waitematadhb.govt.nz/hospitals-clinics/clinics-services/community-child-health](http://www.waitematadhb.govt.nz/hospitals-clinics/clinics-services/community-child-health)
·      Child Development Service, Wellington Regional Children’s Hospital Te Whatu Ora/Capital, Coast and Hutt Valley - [www.ccdhb.org.nz/our-services/wellington-childrens-hospital/](http://www.ccdhb.org.nz/our-services/wellington-childrens-hospital/)
·      Child Development Service, Te Whatu Ora/Health New Zealand/MidCentral - [www.midcentraldhb.govt.nz/HealthServices/ChildHealth/Pages/Child-Development.aspx](http://www.midcentraldhb.govt.nz/HealthServices/ChildHealth/Pages/Child-Development.aspx)
·      Whaikaha – Ministry of Disabled People - [www.whaikaha.govt.nz/support-and-services/specific-disability-services/child-development-services](http://www.whaikaha.govt.nz/support-and-services/specific-disability-services/child-development-services)
·      Early Intervention Foundation ([www.eif.org.uk](http://www.eif.org.uk/))




Early Intervention - What is available to help my child with their learning challenges?

Early Intervention is a term for putting in place extra support for children with disabilities or developmental delays from the age of birth to five-years-old.

It can be a difficult time for the whole family, with visits to medical facilities, sleep deprivation, work disruptions as well as the inevitable confusion and worry.

But pre-school years are precious, both for you and your child, and it is important that this time for bonding, play and exploring the world together, does not take second place to attending to their medical and developmental needs. 

A way to meet these two needs simultaneously is to use Early Intervention techniques at home through play and participation in ordinary family activities. Your child will have their extra support needs met by the people who love them the most, in the environment they feel most comfortable in – their home.

Internationally, parent-focused Early Intervention Plans are acknowledged as the most appropriate way for infants and toddlers to learn.  So, although you will be guided by a team from your Early Intervention provider, they in turn will be guided by your unique knowledge of your child.

**So what can I do?**
- Own your role as the expert on your child’s needs, interests and goals, when developing an Early Intervention plan with Early Intervention Services (EIS), or with a Child Development Team from Te Whatu Ora.
- Maintaining a balanced family life, so that time is prioritised for play, family outings and relaxation, that the whole family can enjoy, will help everyone's stress levels.
- Remember that children are born with an innate desire to explore, learn and play. Use these opportunities to help your child develop. But try not to view it as a ‘therapy session’ – all children learn from their parents - you are just doing what comes naturally. 
- Each child and each family is unique, so experiment with different early interventions strategies. Don’t hesitate to let your early intervention provider know that something isn’t working for you or your child.
- Participation is key - look for ways to include your child in daily routines and activities as much as they can. Adapt your home environment, if necessary, to maximise your child’s engagement. Being active and independent will improve their self-esteem and will accelerate their learning. 
- Think about what activities outside of your home you would like early intervention to support and raise this with your Early Intervention Team. 
- Keep track of the information you are receiving, and ask for clarification if you need it. You should have a designated Early Intervention coordinator, but if not, it is important to keep all the information together.

**What areas of my child’s development will I be working on?**

The big four in terms of early childhood development are **language, movement, cognition and behaviour**.  Depending on what developmental delays or disability your child has, it is likely that a specialist in that area will advise you on ways you can help your child progress at home. 

Again, you have the advantage in that you are deeply familiar with your child as a WHOLE child, rather than seeing them as someone who can be split into separate functions! And often there is an overlap of skills between these different areas of development, such as turn-taking, object permanence, copying, practicing. 

Always keep in mind activities need to be appropriate to your child’s individual needs and abilities. For example, a child with sensory issues might be overwhelmed by loud music and bright lights. 

**Top tips for helping pre-schoolers learn:**
- You are far more likely to ignite your child’s curiosity by letting them do things for themselves.  Use hands-on assistance only as a final resort. 
- Find the ‘just right’ challenge – that is, once your child has mastered a skill, see how you can make it just that little bit harder than what they are already able to do. It shouldn’t be so hard they get discouraged, or so easy that they learn nothing new. 
- Use ‘Assistive Technology’ to help your child do things. These are often ordinary items you can buy at a grocery store, a hardware shop or an arts supplies outlet. For example, you might wrap a drum-stick in foam rubber to make it possible for your child to bang on a drum. At the other end of the scale are computers that help toddlers talk, for example or power chairs that help them move around.
- Observe your child closely and see what they enjoy doing most and how they stay on task. Then observe them doing other activities and the length of time they spend doing it. Always finish an activity when they show signs of restlessness and praise them for their efforts. 
- Give your child choices – we all engage more readily with the activities we choose. But limit the number of choices to two or three, or they may become overwhelmed. You can increase the number of choices as the child gains in confidence.
- Encourage your child to look at books without supervision - they are more likely to become independent readers if they have been able to look at picture books at their own pace and on their own terms. Audio books that they can listen to are also a good option to promote self-directed learning.
- Use play such as dress-ups to develop fine motor skills – buttoning and unbuttoning, pulling up and pulling down, fastening and unfastening.
- Visual supports such as photos or pictures pinned to the wall, can help children remember tasks, schedules and sequences. 

While Early Intervention is all about setting very young children on a positive course for learning and development as they grow, don’t forget to simply enjoy being with your child. Whatever they are able to achieve, now and in the future, children need the reassurance that their parents will love and care for them regardless. 

For more on Early Intervention, check out other panui in this series on Awhi Nga Matua. You might also find the resources below useful, which include website, books and articles from the IHC Library. Or contact the IHC library direct to have a chat about what you need on 0800 442 442 or email: [Librarian@ihc.org.nz](mailto:Librarian@ihc.org.nz).


Early Intervention - How can I help my pre-schooler at home?

early intervention, help for child at home, therapies at home, How can I help my pre-schooler at home?

Cerebral Palsy in Infancy, Early Growth and Development, Infant Cerebral Palsy Intervention, Muscle Activation in Cerebral Palsy, Neuromotor Plasticity in Infants, Early Brain Development in Cerebral Palsy, Motor Impairments and Adaptations, Spastic Paresis in Cerebral Palsy, Skeletal Muscle Changes in Cerebral Palsy, Muscle Development in Children with Cerebral Palsy, Diagnosis and Prognosis of Cerebral Palsy, Motor Activity and Brain Development, Independent Locomotion in Cerebral Palsy, Motor Training for Infants, Lower Limb Performance in Early Infancy, Upper Limb Interventions in Cerebral Palsy, Interactive Technologies in Cerebral Palsy, Cerebral Palsy Research, Cerebral Palsy Treatment, Early Intervention in Cerebral Palsy, Infant Brain Science, Muscle Biology in Cerebral Palsy

Cerebral palsy in infancy: targeted activity to optimize early growth and development - Roberta B Shepherd

"Cerebral Palsy in Infancy is a thought-provoking book which introduces a new way of thinking on the development and use of interventions. Relevant to current practice, it advocates early, targeted activity that is focused on increasing muscle activation, training basic actions and minimizing (or preventing) mal-adaptive changes to muscle morphology and function. The authors present recent scientific findings in brain science, movement sciences (developmental biomechanics, motor control mechanisms, motor learning, exercise science) and muscle biology. This knowledge provides the rationale for active intervention, underpinning the need for an early referral to appropriate services. The book features methods for promoting relatively intensive physical activity in young infants without placing a burden on parents which include assistive technologies such as robotics, electronic bilateral limb trainers and baby treadmills." - PUBLISHER'S WEBSITE

Cerebral palsy in infancy: targeted activity to optimize early growth and development

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