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Audiology and Speech-Language Pathology Service Delivery Considerations in Early Intervention During Coronavirus

Updated July 22, 2020

ASHA is here to assist audiologists and speech-language pathologists, who are key early intervention (EI) professionals, in changing individualized family service plan (IFSP) services, planning alternate interventions, and supporting staff in learning new methods of service delivery.

Federal Guidance on COVID-19 for Children With Disabilities

Find information on states’ responsibilities to infants and toddlers with disabilities and their families/caregivers [PDF], and to the staff serving these children in Part C programs, from the U.S. Department of Education(ED). Current ED guidance allows states to develop temporary solutions and exception policies to initial evaluation, assessment, re-assessment, and transition timelines without risk of noncompliance with federal regulations during this pandemic.

State Information

State governments are considering federal guidance as they take steps daily to address COVID-19 for their constituents, making this a highly fluid situation. Because of this, ASHA strongly recommends that members also look to leaders in their states, including their state/local health departments, EI lead agencies, local EI programs, and state licensing boards for specific information about serving their children and families/caregivers. Check ASHA's state-by-state information to find contact information for various state boards and agencies and current telepractice regulations.

What to Do When EI Programs Are Open or Closed

Under ED guidance, if the office of the state lead agency or EI program or provider is closed, EI services under Part C of the IDEA are not required. If the office remains open, and services can’t be provided in a particular location (e.g., the child’s home or childcare setting) or by a particular provider, the state lead agency must ensure continuity of services. If an office has closed, after it reopens the IFSP team should determine whether the IFSP is still appropriate, or needs updating.

If a state’s EI system remains open and operational, determining specific methods of alternate services (e.g., alternate location, different service provider, consultative services, telepractice) should be done on a case-by-case basis, consistent with the most updated public health and safety guidance, in coordination with the child, family/caregiver, and state lead agency or EI program/provider. You also need to follow existing payer policies and state and federal regulations for telepractice.

Many state and local Early Head Start programs are following the lead of school systems and local health authorities and closing centers.

Telepractice Considerations in Early Intervention

There are special considerations for telepractice in EI settings. In addition to the child’s clinical presentation, clinicians need to consider their skills/competency (in various techniques, such as coaching families), how families feel about telepractice delivery, their access to technology, and their current responsibilities at home.

Visit ASHA’s telepractice COVID-19 page for more resources.

Resuming In-Person Early Intervention Services During COVID-19

As stay-at-home orders ease, the process of resuming in-person services will look different across state and local EI systems. One constant is that the health and safety of EI providers and the children and families they serve remains paramount. Expect that recommendations, requirements, and considerations will need to be adjusted over time, given evolving Part C program regulations and health trends in each community.

The EI population is one of the most challenging for providing in-person services while trying to follow CDC and other public health guidance. Recognizing that children under 2 most likely will not use masks or understand social distancing, providers will need to consider ways to raise their level of protection and that of the other adults and older children in the home. The level of risk must be weighed against the benefits of in-person services. Asking families what they are comfortable with is critical as well.

Ultimately, providers need to determine if they can deliver services in a safe and effective manner using established protocols and/or alternative means. This may take some creative problem solving, such as

  • using caregivers to provide hands-on services or model activities under your direction
  • using images or videos to demonstrate activities
  • having sessions in outdoor spaces
  • scheduling time between sessions to disinfect materials, wash hands, change clothes, etc.

If providers are not able to modify services, they will want to discuss with their IFSP teams, explain the risks and/or compromises in service to families, and consider obtaining informed consent. For some families, it may be helpful to continue via telepractice unless there are mitigating factors.
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Additional COVID-19 Resources for EI Providers and Families

Contact audiology@asha.org or slpinfo@asha.org for additional information and questions related to EI practice.

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