When you suspect your child needs therapy: thoughts from some parents...

Have a strong voice and be persistent - this is for your children. Even if you don't see delays yet, talk about potential future therapy needs if your children are preemie. Research good agencies; I started with MHRA and had a terrible experience (they were disorganized and didn't help me navigate the system), but tried YAI and have had great success. Ask lots of questions!! And you shouldn't feel alone in this. Ask other moms for success they have had with a service coordinator - who is your link and lifeline in getting through this. Specifically, I love Jennifer Hoffman at YAI.

Both of my girls received Early Intervention services, and here are my tips:
1) If you have any doubt at all, get them evaluated--even if your pediatrician disagrees. The worst they can say is that your child does not qualify for services (and that's actually good news!)
2) If your child qualifies for services, the process from evaluation to start date can take up to 2 months or more. Once I knew that my children qualified, my EI service coordinator found my therapist and I started early. I paid out of pocket (got reimbursed partially by insurance), but it was worth it to me get started and not wait.
3) To qualify for EI, your child has to have a 25% delay in TWO catagories (speech/feeding, OT, PT, or Special Instruction). Or they can have a 33% delay in just one catagory to qualify. 
4) A good place to use is YAI. If you don't like your coordinator, you can change. If you don't like your therapist, you  can change. That goes for whichever agency you use.
5) Your EI coordinator can request that all EI meetings be at your home.  
6) Know your rights. EI is getting very strict about giving services out--fight for what your child needs. 

There are a number of agencies which evaluate for and offer Early Intervention services, but we found that NYL/Lifestart was by far the best, with smart service coordinators and very family- friendly, supportive ethos. Our coordinator is Jen Bemak, or you can call head of EI evaluations, Michelle Kohler, 212-418-0328, or point person for services Lisa Entrasser, 212-418-0322. Their office are at 292 Madison at 41st Street. Another route is to go through a developmental pediatrician's referral.

1) Bring up ANY concerns you have regarding developmental delays with your pediatrician first; he should be able to provide a telephone number for Early Intervention Services.
2) Pediatricians can also often provide the names of therapists outside of the EIS network (mine gave me the name of a GREAT speech evaluator and therapist after EIS denied our son speech therapy because his receptive language was ahead of age level although his expressive language is both delayed and difficult to understand).
3) Early Intervention (which covers children up to their third birthday) can only evaluate a child once every six months for free; i.e. if you have your child evaluated in May and services are not deemed warranted, you would not be eligible to receive another free evaluation until November.  So use the evaluation wisely—get as many specialists focused on your areas of concern as possible!
4) To be eligible for EIS, I think a child has to show two areas of developmental delay by 25% or one area of higher percentage delay.
5) Most EI services are provided at a location chosen by the parent—can be your apt., child’s school or day care, etc.
6) After age 3, a child’s services are covered by the Committee on Preschool Education (CPSE), which is generally less generous than EIS with services.  In general, the child would go to the therapist’s office unless the service is provided at the child’s school.
7) At age 5, the Committee on School Education (CSE) takes over.

We were fortunate that the NICU social worker at Columbia Presbyterian advised us to contact EI early and to get our son evaluated as soon as possible.  I also felt fortunate that the therapists that I came in contact with at the hospital (mostly feeding therapists) were familiar with the EI agencies and recommended YAI or Stepping Stone. 

From the time that I contacted Stepping Stone until he was evaluated was 3-4 weeks (typically unheard of).  Given all the changes in the EI program today, I'm not sure what a family should anticipate in regards to a realistic timeline.

I also think that it helps to know who the good/great neuro and pediatric developmental specialists are in the given field and the facilities where they practice or have affiliations (that took me almost 2 months to research).

1. A number of agencies provide therapies such as YAI and Hand in Hand.
2. As much as you don't want to believe your child needs assistance, it's best to catch it in the beginning, so pay attention to developmental milestones. 
3. Get recommendations from other parents for all therapists when you can.
4. Make sure your service coordinator is someone you can rely upon and who will be an advocate for you and your child.  Do not waste time with someone you have to chase, it is valuable time being wasted. 
5. If you feel there is an area in which your child is lacking be very persistent in getting him evaluated - even if they have been evaluated before for the same issue.  Appeal and ask for another evaluation. 
6. The same goes for therapists - if you feel there is not a good fit between therapist and child, switch - it is nothing personal, it is your child's development and you just want someone they will be comfortable with, because they will make more progress quicker. 
7. For physical therapy, my personal experience has led me to PT gyms which have sooo much more to offer than a home.  There are some really good ones in the city so ask your service coordinator to help you find some in your area.
8. Above all don't be afraid to post questions to the group. Many children receive services and there are many parents who will be a great resources.

If you need a physical therapist, we would highly recommend Kelly Sindle. She is terrific at what she does and goes above and beyond.. Not only has she called our doctors to update them on our son's status, but she has also come to appointments with us.   Her number is: 917-608-6542.

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