Early Years Metro ProgramA parent’s guide to early childhood intervention services

Early Years Metro Program

Table of contentsIntroduction....................................................................................................1

What is the Early Years Metro Program?.....................................................1

What does this program offer?.....................................................................1

How are services delivered when my child starts school?........................4

Parent workshops..........................................................................................4

Your rights......................................................................................................6Standard 1: Rights..............................................................................................................6

Standard 2. Participation and Inclusion...........................................................................6

Standard 3. Individual outcomes......................................................................................6

Standard 4. Feedback and complaints.............................................................................7

Standard 5. Service access...............................................................................................7

Standard 6. Service management.....................................................................................7

Your responsibilities......................................................................................7Getting the most out of home visits.................................................................................7

Cancellations......................................................................................................................8

What does my child’s diagnosis mean?......................................................8

How will my child’s diagnosis affect my family?......................................10

Why is early childhood intervention important?.......................................11

What are early childhood intervention services?.....................................12Family-centred intervention............................................................................................12

Developmentally-appropriate intervention.....................................................................12

Structured intervention....................................................................................................13

Evidence-based intervention...........................................................................................13

What can I do to help my child?.................................................................13Build on your child’s strengths and interests...............................................................14

What’s my role in how services are provided?.........................................15

Early Years Metro Program

What will the future hold for my child?......................................................15

Where can I get more information?............................................................16

References....................................................................................................18

Contact details.............................................................................................18

Early Years Metro Program

IntroductionThis parent’s guide is about the Early Years Metro Program and how the Early Years Metro team can support your child and family. The program follows the principles of best practice for early childhood intervention. These principles are based on the Early Childhood Intervention Australia’s (ECIA) National Guidelines – Best Practice in Early Childhood Intervention. This guide provides many answers to parents’ frequently asked questions when they first receive news that their child has been diagnosed with intellectual disability or global developmental delay.

What is the Early Years Metro Program?The program is an early childhood intervention service that provides individualised therapy to children, from birth to six years, who have been diagnosed with global developmental delay and may have other types of disability, such as autism, Down Syndrome or genetic syndromes. The age range is in line with the NDIS Early Childhood Early Intervention (ECEI) approach.

What does this program offer?The Early Years Metro team supports children with disability to fully enjoy and participate in all aspects of their daily lives. The team knows that it is a privilege to enter your home, get to know your family and work with you during your child’s early years.

The team provides intervention based on evidence – such as research, experience, professional skills and knowledge – of what works to support your child and family. Our therapists are highly trained and they work closely with you to ensure intervention is effective and meets your child’s and family’s needs.

Our team includes:

Occupational therapists: They support children to coordinate their smaller muscles so the children can handle objects in their daily lives and during play. They also assist children to learn life skills like dressing themselves and toileting. They also explore and are sensitive to the child’s sensory needs.

Speech pathologists: They focus on how children express themselves and understand others, verbally and through other means. They also help the children to acquire eating and drinking skills.

Physiotherapists: They look at how children use their bodies to balance and move. Working with occupational therapists, they ensure the children have the correct equipment for positioning or mobility.

Psychologists: They help parents understand and deal with their child’s difficult behaviour and emotions.

Family systems therapists: They assist with broader issues that might affect a family with a child with disability, and support the family to work together and learn to enjoy their time as a unit.

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Your child’s therapy team will have a key contact person who will be the main person working with your child and family and is also in close communication with other team members.

Your key contact person will:

Get to know you and your child well. Work with you on all aspects of your child’s abilities and needs. Work closely with you and your child towards your desired goals for your child’s

development and wellbeing. Work closely with other therapists on your child’s team so your child’s developmental

needs can be met.

Figure 1: People who support your child and family

Figure 1 shows that the people closest to the child have the most impact on their development. Therapy works best if families and carers work closely with therapists to support their child’s learning and development.

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The Early Metro Years Program is delivered in four key stages:

Assessment: When families start with the program, we complete a routines-based interview, where we explore how your child communicates, behaves and participates in daily activities, from the moment they wake up till the time they go to bed at night. This allows the team to understand your child’s strengths, interests and areas for further skills development. The team may need more assessments so they can better understand your child’s strengths and challenges. The findings are summarised in a short report, with recommendations on possible goals.

Planning: You and your therapy team will set the goals for intervention, to ensure you have a clear, practical approach relevant to these goals for your child. This will ensure you understand the purpose of an action or process, and your role in this action or process. The frequency of visits depends upon the support you need to reach your child’s goals.

Intervention: Many parents are surprised to hear that the main way young children learn is through things that happen every day, eg during playtime, meal time, bath time, bedtime, shopping trips, etc. The Early Years Metro team will support you to build your skills and confidence in helping your child between our visits. We also problem solve when things don't go to plan, so you can work out what’s best for your child and family.

The intervention is tailored to each family’s circumstances. It can include working in the home, school and or child care, sharing information, knowledge and skills with everyone involved in the child’s care. There are also opportunities to attend workshops – refer to the parent workshops section.

If your child needs equipment to take part in daily activities, your team may recommend and assist in getting the appropriate equipment.Progress: As time goes on, you and the therapy team will discuss:

Are we on track towards our goals? Is this still the most effective way to get there? Is there anything we could add or leave aside?

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Figure 2: The supports that impact on a child’s development

Figure 2 shows a three-year-old’s average week spent various supports. A child can spend up to 80 waking hours with their family (assuming they sleep for 10 hours each day), and may also spend up to 20 hours in child care and one hour of therapy per week (Early Childhood Intervention Australia, 2017). This shows the potential time available for families to support their child’s development during daily routines, compared to one hour of therapy per week provided by professionals.

How are services delivered when my child starts school?Starting school is an important milestone in any child and family’s life. For families of children with global developmental delay or disability, transition to school requires additional thought, time, planning and support to make the process smooth and positive.

Early Years Metro therapists assist families when their child is ready to attend school by:

Discussing possible questions before and after visits to schools. Attending meetings with families to ensure the families’ priorities are considered. Sharing information with the new school, prior to the child starting school, about the

child’s individual strengths and needs. Providing therapy at school once the child starts classes.

When children start at school full-time, families usually want the therapists to focus on helping their child to settle into school. This means there is less time for therapy at home. You and your child’s therapy team will plan together on meeting your child’s goals at home and school.

Parent workshopsThe Early Years Metro program may run the following parent workshops throughout the year.

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It Takes Two to Talk – The Hanen Program for Parents of Children with Language Delays

This program was specifically designed for parents of children with language delays. In a comfortable small group setting, you’ll learn how you can build your child’s language skills naturally during everyday routines and activities.

More Than Words – The Hanen Program for Parents of Children with Autism Spectrum Disorder or Social Communication Difficulties

Created specifically for parents of children with autism or other social communication difficulties, this program provides you with practical strategies for addressing your child’s specific needs and building their communication and social skills during everyday routines and play.

For more information on these workshops, visit The Hanen Centre website (http://www.hanen.org/Home.aspx).

Mealtimes Matter

This workshop provides you the opportunity to reflect on mealtimes, learn how to stretch your child’s food preferences and create a harmonious family meal experience.

Key Word Sign

This is a half-day workshop where participants learn a basic vocabulary of interactive signs, and how to teach children with communication impairment how to sign.

Toilet training

This is a three-hour workshop that teaches you as parents and carers the practical aspects of toilet training children with developmental delays. It also enables you to develop a plan to get your child toilet trained.

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Sleep

This workshop supports you as parents to learn about your children’s sleep cycles, common sleeping problems, and it will assist you to develop a sleep plan to address any problems your child or you may face.

Circle of Security

The Circle of Security parenting program is based on decades of research on how secure parent-child relationships can be supported and strengthened. Parents learn how to understand their child’s emotional needs and how to help their child manage their emotions. Parents also learn how to support their child to feel more emotionally secure and build their self-esteem. They also learn how to build a better relationship with their child.

For more information on this program, go to the Circle of Security website (https://www.circleofsecurityinternational.com/).

Your rights As per the National Standards for Disability Services, your rights in receiving a service include:

Standard 1: RightsYou have the right to be treated fairly when you use disability services.

We keep your personal information confidential and private, as per the State Records Act (2000).

Standard 2. Participation and InclusionThe team can help your child and family to take part in the community and feel included.

Standard 3. Individual outcomesYour service supports you to make choices about what you want to do. You can work toward your goals.

The team will understand your family, recognise your strengths and challenges in a supportive way, and respect your religious beliefs and cultural practices.

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Standard 4. Feedback and complaintsYou can tell the team what you think about the services you receive. You have the right to express any concerns you have about how services are delivered. This helps us to improve the service we provide to families. We greatly appreciate any feedback that you may have, negative and positive.

Firstly, it is important to speak with your therapy team if you have any issues. We are happy to have feedback and work with you to solve the issues.

Secondly, if the problem hasn’t been addressed, you can speak with the team leader or program manager. These people will try to resolve your concerns or tell you about the Department of Communities (Disability Services) formal complaints process. Information on how to make a formal complaint can also be found at http://www.disability.wa.gov.au/.

Standard 5. Service accessFinding and using services is fair. You can access the services you need. The Early Years Metro team can arrange for an interpreter or translator to help your family access our service.

Standard 6. Service managementDisability services should be managed well.

Your responsibilitiesEffective intervention occurs when families and therapists have open and honest discussions. We ask for your full attention in sessions/meetings.

Getting the most out of home visitsAs the Early Years Metro program offers services in family’s homes, we ask:

You provide a safe and clean home environment conducive to therapy and to be ready to participate.

That for the safety of our staff, please restrain any pets during our visits, particularly dogs.

For the safety of our staff, please provide a smoke-free environment. You to respect our rules on food – while we appreciate your hospitality, and we do

not wish to offend – staff have been instructed not to accept food or drink when visiting.

You turn the TV off so that you and your child can get the most from visits by staff.

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CancellationsIllnesses are common in a child’s life, however some children with disability may be more susceptible to illness and complications. We are very conscious of Early Years Metro staff being exposed to infectious illnesses, which may be passed on to other children and families.

We request that you cancel an appointment with us whenever your child is unwell by calling your key contact or a team leader.

Please notify us if your child has any of the following illnesses so we can reschedule the visit:

Influenza/colds. Pertussis (whooping cough). Measles. Mumps. Rubella (German measles). Hepatitis B. Tuberculosis. Varicella (chicken pox). Head lice. Conjunctivitis. Diarrhoea or vomiting.

If a team member is unwell, we will reschedule any appointments with you and your child. This will include visits to your home or to school, day care centre, therapy centre and community settings.

What does my child’s diagnosis mean?Global developmental delay is the term used for children up to the age of six years when they show a delay in two or more areas compared to other children. These different areas of development may include:

Gross motor development – how children move. Fine motor development – how children manipulate objects and use their hands. Speech and language development – how children communicate and understand

and use language. Cognitive/intellectual development – how children understand, think and learn. Social and emotional development – how children relate with others and become

independent.

Sometimes developmental delays are temporary, for example, with children who are born prematurely or who have physical illness or where there is family stress. However, the most common cause of global developmental delay is intellectual disability and this will affect the child into their future.

Intellectual disability is generally diagnosed when a child is six years old. A child with intellectual disability shows a delay in their understanding of the world and takes longer to

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think and learn new skills such as talking, walking, and doing things independently such as dressing and eating. The difference between their development compared to other children becomes more obvious as the child grows older.There is a wide range in the severity of intellectual disability:

Mild intellectual disability may not cause concern until their third or fourth year, for example, when they enter kindergarten and their play, self-help and learning skills are less well developed than children of the same age.

Children who have moderate and severe intellectual disability have a very slow rate of learning and concerns are picked up earlier, usually in the first two years of life because of slow feeding, and lack of interest in toys or people, or a delay in speaking their first words.

Intellectual disability can be caused by factors before, during or after birth. For further information, download the Developmental Delay: An information Guide for Parents published by the Royal Children’s Hospital Melbourne (See References in this booklet).

Despite their diagnosis, a child with global developmental delay has the same needs as any other child, that is, they benefit from a warm and secure and nurturing environment. Children with a delay learn in a similar way to all children but usually take longer to develop new skills.

Many children with global developmental delay will need extra help in one or more areas of their development. They need:

To hear language which is appropriate to their understanding. A variety of ways to learn such as touching, looking and listening. Extra time to learn and practice new skills. To have tasks simplified. To know their efforts are valued.

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Therapists and teachers provide suggestions and advice, but children learn most skills from their family in the early years of life. Professionals work in partnership with parents in early intervention programs, helping them understand their child’s development and special needs.

How will my child’s diagnosis affect my family?Different people view disability in different ways. Some families experience feelings of shame, pity, or may over-protect their child. Some families may be reluctant to tell other people their child has a disability or they may not want to access services, believing their child will “catch up”.

The impact of having a child with any sort of difficulty is different for every family. Children with a severe delay may need a lot of assistance with daily living skills such as eating, talking and dressing. This can place enormous stress on the family.

Some of the common reactions parents may feel include:

Shock – even if it has been suspected for a long time. Guilt – “What I have done wrong to deserve this?” Shame or fear – “What will other people think?” Anger – “Is this punishment?” Sadness – especially when thinking about your disappointed hopes and dreams for

your child and yourselves. Grief – related to the change in expectations for your child’s future. Desperation – a need to “do something”. Relief, especially if you’ve been worried about your child’s development for a while.

A diagnosis often means you can start asking questions and making decisions. Feeling confused – with too much information, conflicting advice and pressure to

make decisions. Feelings of frustration or failure in the parent. Uncertainty about the future.

These reactions are normal. They may be ongoing throughout your child’s life, eg when starting or leaving school, looking for work or leaving home.

Most families, particularly parents, find the following helpful:

Having their questions answered. It is sometimes helpful to write questions down so you get immediate answers when you seek advice about your child.

Getting support to understand your child’s developmental delay, including the opportunity to share your feelings, hopes and fears. Support may come from other family members, friends, parents with similar experiences and professionals.

Information on essential services and how to access them. Learning how you can support your child in the best possible way. Having a break. Time off from caring for your child is important particularly when

your child’s daily needs place extra demands on your time and energy. Having some time off will enable your family to rest, recharge and spend time doing other enjoyable things.

As with any family, strong support from extended family and friends will help you feel more positive in dealing with your child’s diagnosis.

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There’s no ‘right’ way to feel. You can’t prevent your feelings, and you shouldn’t try. Dealing with your feelings is part of coming to terms with the diagnosis and moving on with your life, your child’s life and your family’s life.

If you have feelings of uncertainty or frustration which persist or when behaviour problems fail to resolve, it is generally helpful to talk about these difficulties with someone on the therapy team who is familiar with your child.

The Raising Children website (http://raisingchildren.net.au/) has information on relevant topics such as:

Your feelings about your child’s disability. Talking about your child’s disability. Disability: helping siblings.

Why is early childhood intervention important?The early childhood years lay the foundation for all future development.

Recent scientific evidence shows early experiences literally shape our lives by affecting the way the young brain develops. What happens to us in the early years has a major effect on our health and social development right through to adulthood.

The early years are also critical for the whole family. This is when families can best begin to learn how to support and nurture their child, how to meet their child's needs, and how to adapt positively to having a child with disability or global developmental delay.

For more information see the booklet on “Early childhood neurodevelopment” on the Kidsmatter website:

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https://www.kidsmatter.edu.au/early-childhood/resources-educators-and-families/ebooksBelow are the Early Childhood Seven Key Principles in the Early Childhood Intervention Australia’s (ECIA) National Guidelines for Best Practice (2016):

Infants and toddlers learn best through everyday experiences and interactions with familiar people in familiar contexts.

All families, with the necessary supports and resources, can enhance their children’s learning and development.

The primary role of the early intervention service provider is to work with and support the family members and caregivers in a child’s life.

The early intervention process, from initial contacts through to transition, must be dynamic and individualised to reflect the child’s and family members’ preferences, learning styles and cultural beliefs.

Individual Family Service Plan outcomes must be functional and based on children’s and families’ needs and priorities.

The family’s priorities, needs and interests are addressed most appropriately by a primary provider who represents and receives team and community support.

Interventions with young children and families members must be based on explicit principles, validated practices, best available research, and relevant laws and regulations.

What are early childhood intervention services?Research from The Raising Children’s Network website (see References in this booklet) tells us that all therapies and services for children with disability should be family-centred, developmentally-appropriate, structured and evidence-based.

Family-centred interventionThis means that the Early Years Metro team:

Recognises each family’s strengths while understanding their challenges. Understands that each family is unique and is respectful of different cultures. Recognises the family’s special knowledge of their child. Works together with families to identify priorities and develop intervention strategies

in daily routines. Provides services that consider unique family and home situations, and ensure

services can be provided at home and at day care and schools.

Developmentally-appropriate interventionThis means the team:

Works with your child in ways that consider your child’s development, interests and strengths.

Includes strategies to help your child learn new skills and use them in different settings.

Prepares and supports your child for the move to school. Supports your child to participate in community activities that are developmentally

appropriate.

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Structured interventionThis means the team:

Works with the family to develop an individual plan for their child and reviews the plan regularly.

Ensures therapists communicate with each other to plan and carry out activities as a team so activities are all linked.

Helps families understand their child’s assessments results. Consults with other professionals such as paediatricians and teachers.

Evidence-based interventionThis means the team:

Will ensure therapies and services are specially designed for children with disability. Use interventions that research has shown are effective. Will ensure the services are delivered by qualified and expert professionals.

Families will build a strong relationship with their child’s therapists, particularly their key (main) contact. When problems arise, families are encouraged to discuss their thoughts and ideas openly, in a spirit of trust and cooperation.

What can I do to help my child?Early intervention services help families develop skills and knowledge to continue to help their child into their future. For this to happen, families need to be actively involved in everything that happens – planning, trying new strategies, practicing and evaluating.

Early intervention programs recognise that parents’ interactions with their child are important. During sessions, therapists will act like a “coach” – helping parents and carers maximise learning opportunities when they interact with their child.

Our staff help parents make the most of everyday life so that therapy isn’t something to fit into busy family life. We will help look at ways throughout your day for opportunities to help your child learn and develop. Here’s some everyday ideas to help your child:

Involve and interact with your child during all daily routines. Make time to have fun with your child. Make sure you give your child your full attention as often as you can. It’s great if you can get down on their level and join in their play. Get other people involved in your child’s learning.

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Build on your child’s strengths and interestsWhen you want to support your child to learn, their everyday interests are a great place to start. When your child is doing something that interests them, they are more likely to feel motivated and willing to learn.

Early Years Metro staff will spend time by watching and playing with you and your child to find out what interests your child, specifically:

What makes them smile or laugh? What gets their attention? What do they naturally like to do? If your child has limited language or play skills, what do they point to or look at? What excites them or calms them down?

If your child doesn’t seem to have any particular interests, we can help try out some different play activities, toys and experiences, like listening to music or watching bubbles.

It’s good to involve other people in your child’s learning – these people might be your child’s grandparents, child care workers and your extended family. This will help create consistency while your child is learning new skills.

You could also talk to your child’s preschool or school teachers about strategies they find helpful, so you can use the same strategies at home to develop your child’s confidence and skills.

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What’s my role in how services are provided?You are the most important person in your child’s life, and you are at the centre of your child’s early intervention team.

As a parent you have many roles including:

Making decisions: As we are working with your child and your family, what happens in early intervention should reflect the issues that are important to you. Therapists will support you in getting the information you need to make decisions, so your plan will achieve your goals.

Communicating: Talk freely and openly with the therapy team so they understand your needs and how they can best help you and your child.

Connecting: All parents teach their children throughout the day, however it’s also important to spend time having fun together. Not only is it enjoyable for both of you, a good relationship is vital to help your child learn and develop in all areas.

Planning: Your family and the therapy team will set goals for the coming year. Looking after yourself: Your wellbeing is essential for the wellbeing of your child. If

you feel that your early intervention activities are putting pressure on you, with no time for other things, talk to your therapy team about how things are going for you, or to someone like a family worker or counsellor.

What will the future hold for my child?It’s natural for parents to wonder what the future will hold for their child. Parents have questions such as:

Will my child make friends? Will my child be able to get a job? Will my child be able to live independently?

In the early years of life, it is impossible to answer these questions. It is important to be optimistic about your child’s progress, yet realistic about the issues they will face.

All children, however, continue to learn. As adults they will also develop new skills. Each new skill contributes to your child’s ability to find enjoyment in activities and participate in society. It is important to celebrate your child’s achievements through their life. If you have any concerns, discuss them with your therapy team.

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Where can I get more information?Activ Library

Activ Library is a major library for disability related information in Western Australia.

Visit https://www.activ.asn.au/library.

Australian Government, Department of Social Services

Disability rights ensure that people with disability are treated the same as the rest of the community. There are two main Acts in Australia for people with disability:

Disability Services Act (1993) and the Commonwealth Disability Discrimination Act (1992). More information can be found at https://www.dss.gov.au/.

The National Standards for Disability Services has been translated into 15 languages – Arabic, Assyrian, Chinese (simplified), Croatian, Farsi, Greek, Khmer, Korean, Italian, Macedonian, Serbian, Spanish, Tagalog, Turkish and Vietnamese. More information at https://www.dss.gov.au/our-responsibilities/disability-and-carers/standards-and-quality-assurance/national-standards-for-disability-services.

Department of Communities (Disability Services)

The Department of Communities (Disability Services is the WA State Government agency responsible for advancing opportunities, community participation and quality of life for people with disability. More details available at www.disability.wa.gov.au.

Developmental Disability WA

Developmental Disability WA is an advocacy agency representing families, organisations and individuals concerned with the rights and needs of people with intellectual and other developmental disabilities. The agency advocates for the rights of people with disability and for the provision of the opportunities, support and services they and their families require. For more, go to https://ddwa.org.au/.

Early Childhood Australia

Early Childhood Australia is the peak early childhood advocacy organisation, acting in the interests of young children, their families and those in the early childhood field. The organisation advocates for quality outcomes in early childhood education and care, and provides resources to help early childhood educators achieve this goal. Visit http://www.earlychildhoodaustralia.org.au/.

Early Childhood Intervention Australia

Early Childhood Intervention Australia is the peak body for early childhood intervention in Australia, representing professionals and organisations that provide services for young children with disability and developmental delays, and their families. Go to https://www.ecia.org.au/.

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Ethnic Disability Advocacy Centre

The Ethnic Disability Advocacy Centre is the peak advocacy organisation in WA and aims to safeguard the rights of ethnic people with disability and their families.

Get more information at http://www.edac.org.au/.

Kalparrin

Kalparrin helps families of children with disability and special needs to carry their load by providing practical information and support, and connecting them with the services that they need. Explore details at http://kalparrin.org.au/.

Kids Matter

Kids Matter was developed by mental health professionals and education and childcare staff in response to the high rates of school-age children with mental health difficulties and the problems they face getting help. It is a partnership between education and health sectors and is funded by the Australian Government and non-profit organisation beyondblue. Details available at https://www.kidsmatter.edu.au/.

NDIS

The National Disability Insurance Agency (NDIA) is an independent statutory agency, whose role is to implement the National Disability Insurance Scheme (NDIS), which will support a better life for hundreds of thousands of Australians with a significant and permanent disability and their families and carers. Go to https://www.ndis.gov.au/index.html.

Raising Children Network

This is the Australian Government parenting website that has information on all aspects of child development and parenting, including children with disability.

Get more information at http://raisingchildren.net.au/.

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ReferencesDown Syndrome Australia (2016). Treloar, R. Is this the right service for me? The Voice: Journal of Down Syndrome Australia (Vol 4, Issue 3) pp 5-8.

Early Childhood Intervention Australia (2016). National Guidelines on Best Practice in Early Childhood Intervention. ECIA: Sydney.

https://www.ecia.org.au/resources/best-practice-guidelines

Early Childhood Intervention Australia (2017). Choosing Quality Early Childhood Intervention Services and Supports for Your Child: What you need to know. ECIA: Western Australia. https://www.ecia.org.au/resources/family-booklet

Plumtree – Early Childhood Early Intervention for children 6 and under. https://plumtree.org.au/ndis/#ecei-approach

Raising Children Network – Children with disability

http://raisingchildren.net.au/children_with_disability/children_with_disability.html

Royal Children’s Hospital Melbourne (2009) Developmental Delay: An Information Guide for Parents.

http://www.rch.org.au/uploadedFiles/Main/Content/cdr/Dev_Delay.pdf

Contact detailsTo find out more about the Early Years Metro Program, or to refer your child, contact the Early Years Metro team. If you work with the child or family, you may also make a referral on their behalf, with the family’s consent.

Early Years Metro ProgramDepartment of Communities (Disability Services)

Address: 71-73 Norma Road (Cnr Marmion St), Myaree 6154

Phone: 9329 2400 / 9329 2407

Email: DSCProfessionalServices@communities.wa.gov.au

Fax: 9329 2499

Website: www.disability.gov.au

© Department of Communities 2018.

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