FAQs

Early intervention is a program that provides services to children from birth to age five. The program is instituted through the Individuals with Disabilities Education Act, Part H for infants and Toddlers and Part B for three to five year olds. Part H is governed by the Department of Public Health, and Part B is through the State Department of Education. Children may be eligible if they are (1) at established risk because they are diagnosed with a condition known to result in a disability or delay (2) at biological risk because of prenatal, perinatal or postnatal histories suggest an increased vulnerability to disability or delay or (3) at environmental risk because the conditions in their surroundings might result in a disability or delay.

Brachial Plexus Palsy would qualify the children under the first eligibility in most cases depending on the severity of the injury, the state that you live in (there may be different criteria to become eligible, such as two areas of need, or two standard deviations from the average etc.), and sadly the experience of the case manager and the tenacity of the caregiver.

The first step is to find if your child is eligible. The Early Intervention program will screen your child using an assessment tool that is age and developmentally appropriate. Assessment instruments include a variety of standardized and criterion references instruments which provide information across the traditional areas of development including cognition, fine and gross motor development, receptive and expressive communication development, social-emotional development and self help. A comprehensive assessment process includes the gathering of information about a wide range of a child's abilities, and parents have the most extensive information in such areas as motivation, interactive abilities, learning style and tolerance for learning. Lastly, if assessment is viewed as an integral part of intervention, then parent participation in assessment introduces the parent as an equal partner in facilitating their child's development.

If your child is found eligible an Individualized Family Service Plan (IFSP) will be developed. The IFSP is required for the provision of early intervention services for eligible infants and toddlers (aged birth to three) and their families and serves as the planning documents, which shape and guide the day to day provision of early childhood intervention services. An Individualized Education plan (IEP) is developed for children 3-5, although with agreement with the school system that administers IEP's, an IFSP can be employed for ages 3-5.

What services may be included in an IFSP? (from 34 Code of Federal Register (CFR) $303.12(d))

  • family training, counseling, and home visits
  • special instruction
  • speech pathology and audiology
  • occupational therapy
  • physical therapy
  • psychological services
  • case management services
  • medical services only for diagnostic or evaluation purposes
  • early intervention, screening, and assessment services
  • health services necessary to enable the infant or toddler to benefit from the other early intervention services
  • social work services
  • vision services
  • assistive technology devices and assistive technology services
  • transportation and related costs that are necessary to enable an infant or toddler and the infant's or toddler's family to receive early intervention services

The field of early childhood intervention must be prepared to use any technology necessary to enhance a child's development. So even if a particular service isn't currently offered by the provider, if it can be shown that it contributes towards the development of the child in a way that other services cannot, then they must consider the service. Aquatic Therapy is one such service that can be fought for. Some of these services may be offered in-house, at the agency or at a hospital/medical facility, however the delivery of services must be tailored to the needs of the child and family-not at the convenience of the EI providers.

Physical therapy and occupational therapy are very important in preventing contractures (muscle tightness) and in maximizing muscle strength and sensation in individuals with brachial plexus injuries. Therapy should be started within the first week after birth and continued typically for years. In general, occupational therapists are trained mostly in arm and hand therapy, while physical therapists deal with the whole body. Often occupational therapists are more familiar with brachial plexus therapy issues. In the pediatric field, it is often difficult to find occupational therapists in many cities and physical therapists are used with great success.

Many schools offer assistance with the ADA (Americans with Disabilities Act).  You can go to the counseling center at your school or university and get assistance there. They are people that can take notes for you and even write your exams.

Make sure you talk to the anesthesiologist prior to the surgery and stress that neither arm should be rotated away from the body (the usual position, particularly if it is abdominal surgery is to rotate the arm out about 90 degrees). Some even position it over the head, which is a real "no no" for us. Ask the anesthesiologist to tuck the arm to the side.

Also if there is Horner's Syndrome present, this is also critical, as one pupil will be smaller than the other which could lead them to think that there is something else happening (like brain damage) when it is not. Make sure they look carefully prior to the surgery to determine any differential in pupil size and iris color.

Do not let them take blood pressure or put the IV into the bpi arm under any circumstance. False readings can happen and the arm can be injured further.

Beginning in 1999, UBPN has promoted an Annual Brachial Plexus Awareness Week during the 3rd week in October. That month was chosen as it is National Disability Month. Our goal is to have a national proclamation declaring this week officially in the year 2005 and we are working towards that goal. The Fall issue of Outreach is considered our Awareness issue and we gear our articles toward this broader perspective. Awareness is part of our mission and it infiltrates all that we do.

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