What's the Point of Center-Based Intervention?

Posted by Ashley, Special Educator

In the field of Early Intervention, the majority of services are provided within a child's home.  This is a widely accepted model and there are many advantages to home-based instruction.  One primary strength is that the child is being taught in his/her home environment, hopefully making the instruction  age-appropriate, natural, and meaningful.  This allows therapists the wonderful opportunity to integrate instruction into the child's already existing daily routines (e.g. making lunch, brushing teeth, getting the mail, etc.)!  It is also beneficial because it makes parent involvement a little easier.  When therapy is provided in the home, parents are more likely to be included and to be treated as collaborative partners, which is hugely important!  It also allows regular opportunities for the therapists and caretakers to observe one another and offer support.  So, with all of these great benefits to home-based instruction, what's the point of center-based intervention? (Hint: there are many benefits, so keep reading!)


As professionals in an Early Intervention Center, we obviously support center-based instruction!  Although home-based instruction can be very beneficial, I believe that there is also great value in center-based instruction.  Unfortunately, the importance of center-based programs is often overlooked!  In my professional opinion, a combination of home-based and center-based intervention is ideal for most young learners, especially those who fall on the autism spectrum.  Let me tell you why...

The first reason is that children on the autism spectrum typically present with delays in social-emotional development (this is part of an autism diagnosis).  Although good home-based therapists will address some social goals, they may have limited opportunities and resources for doing so.  A key element of social development is teaching our young learners how to build relationships with other children, not only with adults!  In a home setting, especially when there are not other siblings present, this may be difficult.  Home-based therapists certainly have other options, such as taking the child to the park or another social setting, but these types of outings may not provide the child with repeated experiences with the same children.  Think about it: how often do we randomly develop meaningful friendships with a stranger we encountered one time at the park?  We are much more likely to develop relationships with people we see on a more regular basis, right?  Now consider the fact that many of our learners have delayed social skills and may need more direct instruction and repeated practice.  Doesn't it make sense to provide our students with the opportunity to engage regularly with familiar peers?  Isn't that how meaningful relationships typically develop?  That is exactly what center-based intervention can provide that may be difficult to provide within the home!

Now, it is worth noting here that one criticism of self-contained classrooms in general is that learners are not provided with typically-developing peer models.  I hear this concern.  In my ideal world, Early Intervention centers would also include typically-developing learners, following more of an inclusion model.  However, it is also important to recognize that students with special needs all have different strengths, and can still learn from one another.  Students with special needs are also capable of developing meaningful friendships with one another.  Talented center-based therapists will maximize social learning opportunities and model appropriate social skills.

Another key element of center-based programs is that they can help prepare young children for the transition to preschool.  The transition to a school setting can be difficult for any child, with or without special needs.  Suddenly children are being placed in a new setting, with unfamiliar people, and with new demands and expectations!  That can be a pretty big deal to any child!  This may be an especially big deal to a child with special needs, for whom change and transition may already be challenging.  A good Early Intervention center will provide its students with a jump-start on preschool readiness.  In my opinion, Early Intervention centers should be modeling a preschool setting, to whatever extent is developmentally appropriate for its learners.  By doing so, we are allowing the children to practice daily classroom routines (e.g. checking the schedule, cleaning up toys, washing hands, etc.) and to learn the behaviors that are often important in preschool (e.g. sitting on a rug for story time, sharing toys, etc.).  By doing this, we are setting our students up for success in their next settings.  Many of these skills are difficult to address in a one-to-one home-based setting, but are appropriate to address within a center-based program.

Finally, in my experience, there are many professional benefits to being a therapist in a center-based program.  These benefits translate into benefits for the families and students.  Typically, center-based programs provide a wealth of professional development opportunities.  This environment also allows regular communication amongst therapists and promotes collaboration amongst team members (something that can be a challenge for home-based teams).  Just as children have varying strengths and needs, so too do therapists.  Working in close quarters with other therapists provides opportunities to support and learn from one another.  Professional collaboration results in stronger therapists and better services for the families.  Center-based therapists are also provided with constant supervision, which is not consistently available for home-based therapists.  These may be important benefits for both parents and professionals to consider.

Although there are certainly many more benefits to choosing center-based services, these are the fewthat are most important to me, and that are probably most important to many parents!  A combination of home-based and center-based services can provide our little learners with a more comprehensive educational experience.  Both forms of therapy have different strengths and both can be beneficial if implemented appropriately.

Unfortunately, the truth is that some Early Intervention centers squander this opportunity and do not provide appropriate services.  (For the record, many home-based therapists also squander appropriate teaching opportunities!)  A great many programs focus solely on providing one-to-one discrete trial training (DTT) and fail to incorporate social skills support, peer interaction, group instruction, and preschool preparation.  (Parents, keep an eye out for this as you tour different programs!)  Just to clarify, I am not bashing discrete trial training here (DTT).  I have already mentioned in previous posts that this type of instruction may benefit many young learners in acquiring certain skills.  But, by providing only this type of instruction in center-based programs, I think we're really doing our students a disservice!  We can and should be doing so much more than that!

Is that really the point of center-based instruction?  For children to sit alone with a therapist for a few hours?  Can't the children be getting that type of instruction from their home-based therapists?  If that's all we're going to do, then why not let the child get those services in the comfort of his/her home?  Why make them get on a bus and ride to school if we're not going to provide them with anything different?  Where's the sense in that?  We should be providing them with something that they're not able to get at home!  If we're not doing that, then what are we doing?
  
To my fellow center-based Early Interventionists, please take some time to really think about your students' needs!   As center-based professionals, let's make sure that we are providing what the children may not be getting otherwise (e.g. peer interaction, group instruction, a classroom environment, etc.)!  Let's help them to get a complete and well-rounded Early Intervention experience!  The best way we can do this is to provide opportunities for social development and preschool readiness!  If that's not the point of center-based intervention, then what is?  Just a thought...