Showing posts from January, 2011

Comments made at the NYS Medicaid Redesign Public Hearing

I was impressed with the good attendance at the public hearing and the attendees represented a Who's Who of Health Care and Human Service Providers in WNY. There were CEOs from most major hospitals, directors of community service programs, community activists, and consumers. Their interests ranged from emergency room care, medicaid transportation, primary care providers, hospital and nursing home care, residential programs for people who have developmental disabilities, mental health agencies, substance abuse agencies, and so many more. I was deeply saddened that I was the only person there who talked about Medicaid in education and early intervention. These comments were hashed together from old blog posts and other rantings: My name is Christopher Alterio and I am a pediatric occupational therapist. Thank you for the opportunity to provide information from a street-level provider's perspective on the Medicaid program and funding for early intervention, preschool, and sc

The roulette wheel of qualifying for preschool special education services.

I received a referral today for Trevon, who I initially evaluated eight months ago. His mother was concerned about his development and asked the school system for help when he turned three years old. The initial OT evaluation indicated that he had significant fine motor delays and a speech evaluation indicated that he had significant speech and language delays. The school approved speech therapy and a special education teacher but declined the occupational therapy. Eight months later, I received an authorization to provide services because the motor concerns were impacting his participation in preschool. In the interim months when there was no OT intervention a second OT evaluation was completed which had essentially identical findings to the first evaluation. Apparently, the lobbying efforts of the preschool teacher and speech language pathologist helped convince the district that the OT services were required. There are many studies that have been completed that discuss the valu

A new study on SI effectiveness but measurement conundrums persist

Just a quick couple thoughts as I got a few emails asking me to comment on an article in the new AJOT. The study people are interested in is Effectiveness of sensory integration interventions in children with autism spectrum disorders: A pilot study. (linked for those of you who have access). The study found that both intervention groups demonstrated significant improvements toward goals on the Goal Attainment Scale, but the SI group demonstrated more significant improvement than the FM group. Also, the SI group displayed significantly fewer autistic mannerisms than the FM group as measured by a sub test of the Social Responsiveness Scale. One of the nicest features of this study is that the researchers completed a series of fidelity measures on the interventions. This is a big step forward because so many of our research studies state that the intervention reflects sensory integration but this particular effort describes a solid fidelity test for each of the interventions provide

Occupational therapists are beginning to ask questions about Interactive Metronome

The questions about Interactive Metronome have been coming fast and furious the last few months, perhaps associated with their increased marketing - although that is my own speculation. I am also aware of some franchised 'brain therapy' centers that are using the intervention protocol so that might also be driving some of the questions. Anyway, I recently received this email, which reflects the typical question: Thank you for your candid thoughts. I loved reading your blog and stayed up until 3 in the morning doing so. I am an OT who has been practicing in pediatrics for 12 years and have never really bought into the whole SI thing; I thought maybe I did not really get it. I have always felt like sensory issues are part of the big picture but have never observed them to be an isolated concern that is fixed by swinging or brushing. I have had some parents ask me about interactive metronome and some therapists I know swear by it. What are your thoughts? Does it have the resear

Occupational Therapy Job Opportunity in DC!

In partial fulfillment of my ongoing public service mission, I wanted to bring a job opportunity to everyone's attention. There is an interesting article in The Washington Examiner today that talks about the DC area Department of Youth Rehabilitation Services wanting to find someone who can teach yoga or tai-chi to children in the program. I am sure that educating at-risk children in stress management and situational coping strategies is probably a good idea. However, this isn't the only issue in the article that got my attention. According to the article, the Interim Director got some people suggesting other programs including building a race car, involvement in music programs, and instruction in boxing. As I read this I couldn't help but think that there were some needs in that program that were obviously not being met. The article states that "Ward 1 Councilman Jim Graham questioned if turning to yoga was the best approach given the problems the youth face."

What early intervention providers need to know about administrative rule changes, Part One

The NYS Early Intervention Program recently issues some FAQs on some regulation revisions that happened in June 2010. These changes are insidious and fly beneath the radar of most people because they constitute rules and regulations that can be administratively altered without a full deliberative process that is associated with actual changes to law/statute. I figured I would post this today because it is a new year and I think that everyone needs to keep their ears to the ground for changes in rules and regulations that will have a significant impact on the way that health care is delivered on local, state, and federal levels. This particular gem places additional stress on an already over-burdened New York State Budget. The regulation states that social security numbers and citizenship are required for participation in the early intervention program, BUT NOT REALLY. June 2, 2010 - Webinar 1 - Overview of Revisions to the EI Regulations Frequently Asked Questions 1. Question: Are p