Karrie Kingsley, Zoe Mailloux; Evidence for the Effectiveness of Different Service Delivery Models in Early Intervention Services. Am J Occup Ther 2013;67(4):431-436. doi: 10.5014/ajot.2013.006171.
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Consideration of the evidence for all aspects of service delivery is a growing relevant concern of occupational therapists, including those providing early intervention to children and families. We conducted a review of the literature to uncover what evidence existed for determining the effectiveness of different service delivery models and methods used to improve occupational performance for children and families who receive early intervention services. Through a comprehensive search, we reviewed and synthesized studies, finding common themes of family-centered and routine-based approaches, service setting, and the inclusion of parent participation and training. Families consistently reported positive perceptions of family-centered and routine-based approaches. Parent participation and training resulted in positive outcomes. No specific setting or method of service delivery was identified as clearly most effective, with most studies reporting combined approaches and environments for interventions.
Because a family-centered approach was generally well received and resulted in favorable outcomes, the continued use of this approach in occupational therapy interventions is supported.
Because no clear results demonstrated better outcomes in specific settings (e.g., home vs. clinic vs. community), occupational therapists will best serve their young patients and families by offering individually tailored interventions that provide the optimal combination for each situation, rather than a subscribed plan.
Because positive outcomes varied widely across service delivery methods (e.g., decreased maternal depression, enhanced developmental levels, future academic performance), occupational therapists will want to consider a range of postintervention assessments to determine the effectiveness of their programs.
Therapist feedback was shown to increase outcomes of groups; thus, occupational therapists may wish to review and increase their efforts to provide feedback to participants.
The fact that parents were shown to highly value training that facilitates their skills in improving communication, play, and behavior outcomes reveals a natural fit for occupational therapy intervention and may assist in guiding therapists to frame components of their programs around these important considerations.
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